3 cases of digestion tract tuberculosis treated in Hospital 108 were presented. The first was operated because of intestinal obstruction, the second because of severe gastrointestinal bleeding, but biopsy showed that these two patients were treated intensively by antituberculosis chemotherapy with good success. The third was diagnosed and treated very lately loading to unsatisfied results. Therefore, it should be tried to treat with antituberculosis drug initially
Tuberculosis ; Digestion ; Diseases ; Tuberculosis, Gastrointestinal ; diagnosis ; Therapeutics

Intestinal tuberculosis is an infection of the gastrointestinal tract by the Mycobacterium tuberculosis complex. To the best of our knowledge, solitary intestinal tuberculosis accompanied by intestinal obstruction, particularly in the middle of the small intestine, is extremely rare. We report a case of solitary jejunal tuberculosis in a 49-year-old man with no underlying disease. He was admitted a few days after the onset of diffuse abdominal discomfort. Upon evaluation, we initially considered a malignancy of the distal jejunum with ileus due to the presence of a mass. Therefore, he underwent laparoscopic resection of the small bowel. Unexpectedly, the histologic specimen showed a chronic caseating granulomatous lesion with acid-fast bacilli. Ultimately, he was diagnosed with solitary jejunal tuberculosis. He was successfully treated with anti-tuberculosis drugs without any complications.
Gastrointestinal Tract ; Humans ; Ileus ; Immunocompetence ; Intestinal Obstruction* ; Intestine, Small ; Jejunum ; Middle Aged ; Mycobacterium tuberculosis ; Tuberculosis* ; Tuberculosis, Gastrointestinal

PURPOSE: The purpose of our study was to evaluate clinical and CT findings of paradoxical response during treatment for abdominal tuberculosis. MATERIALS AND METHODS: Authors reviewed the patient records of 138 patients with abdominal tuberculosis during a recent 6-year period and we selected 11 patients with a paradoxical response. The CT findings and pathologic findings of the initial lesions and new lesions were reviewed. The intervals between initiation of therapy and the detection of new lesions, improvement of new lesions and the final follow-up were evaluated. RESULTS: At the initial presentation, we identified tuberculous peritonitis in 8 patients, tuberculous lymphadenitis in 3 patients and ileocolic tuberculosis in two patients. New lesions were identified at 2-10 months (mean: 3.8 months) after the initiation of therapy and following improvement of the initial lesions. The new lesions were perihepatic caseous abscess (n=4), hepatic tuberculoma (n=3), hepatic caseous abscess (n=1), tuberculous lymphadenitis (n=3), ileocolic tuberculosis (n=3), and splenic tuberculoma (n=1). Improvement of new lesions was noted at 4-14 months (mean: 7.6 months). At the final follow-up of seven patients, the new lesions disappeared and four patients still had small residual lesions. CONCLUSION: New lesions that develop in a patient with initial improvement should be considered a paradoxical response that will ultimately improve with continuation of the original medication.
Abscess ; Follow-Up Studies ; Humans ; Peritonitis, Tuberculous ; Tuberculoma ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Lymph Node

Tuberculosis is a multi-organ disease. The incidence of pulmonary tuberculosis is declining due to improvement in public health, vaccination and the development of anti-tuberculosis medication, but extrapulmonary tuberculosis has become more common, especially in immuno-compromised individuals, AIDS patients and immigrants to western worlds. Gastrointestinal tuberculosis continues to give rise to diagnostic and therapeutic challenges. The jejunal tuberculosis is uncommon and presents a difficult diagnostic problem. Bleeding jejunal tuberculosis is a very rare source of lower gastrointestinal bleeding. We have recently experienced a case of a jejunal tuberculosis which was proven to be a source of gastrointestinal bleeding by intraoperative endoscopy and was confirmed by surgical exploration. This report summarized our experience and review of literature.
Emigrants and Immigrants ; Endoscopy* ; Hemorrhage* ; Humans ; Incidence ; Public Health ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Vaccination ; Western World

Esophageal and duodenal tuberculosis are rare form of gastrointestinal tuberculosis. The common complications due to esophageal and duodenal tuberculosis are fistulous communications with the adjacent structures, perforation, obstruction, and upper gastrointestinal bleeding. Massive bleeding in esophageal and duodenal tuberculosis is quite rare. We encountered a case of a 55-year-old male who presented with hematemesis and melena. Esophageal and Duodenal tuberculosis with a duodenal fistula was diagnosed by an endoscopic and radiology examination. He improved after treatment with anti-tuberculosis medication over a 9 month period. We report this case of esophageal and duodenal tuberculosis associated with pulmonary tuberculosis with a review of the relevant literature.
Duodenum* ; Esophagus* ; Fistula ; Hematemesis ; Hemorrhage ; Humans ; Male ; Melena ; Middle Aged ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary*

BACKGROUND/AIMS: We investigated the clinical features, and treatment outcomes in patients with non-traumatic small bowel perforations and compared these results to the previous study with patients who were diagnosed between 1997 and 2002. METHODS: Patients who diagnosed non-traumatic small bowel perforation between January 2003 and December 2008 were reviewed retrospectively. RESULTS: Of 38 patients of non-traumatic small bowel perforation, the most common etiologies were Crohn's disease (CD) (36.8%), followed by intestinal tuberculosis (ITB) (28.9%) and primary malignancy (15.8%). In the study of 2002, however, the most common etiologies were idiopathic (39.3%), followed by mechanical obstruction (28.6%) and infectious enteritis (14.3%). Of 38 cases, 8 perforation sites were found in the jejunum and 30 in the ileum. The number of perforations was single in 20, two in 15, and over 2 in 3 cases. Twenty-five patients were treated with resection and anastomosis, nine patients with primary closure, and four patients with both procedures. The site and number of perforations, surgical methods, and post-operative complication rates were similar to those of 2002. The perforation patients with ITB had more frequent night sweats and pulmonary tuberculosis findings than those with CD. CONCLUSIONS: Although the clinical features and surgical outcomes in the 2009 study were similar to those of the previous study conducted in 2003, the etiologies of perforations were different; CD and ITB were two most common etiologies. In addition, clinical characteristics such as night sweats or pulmonary tuberculosis were suggestive findings for the diagnosis of ITB.
Crohn Disease ; Enteritis ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Sweat ; Tuberculosis ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary

INTRODUCTION: In the Philippines, a diagnosis of pulmonary tuberculosis  is  very  common  especially  in  the  presence of sputum findings positive for Acid Fast Bacilli (AFB).  But it should be kept in mind that not all Mycobacterium are tuberculosis(TB).A  previous  study  done  at  the  University of Santo Tomas (UST) Hospital from 2003 to 2009 showed a 2.17% incidence of Mycobacterium other than tuberculosis (MOTT). However, due to its growing correlation with the Human Immunedeficiency Virus (HIV), updated incidence rates  are  warranted.Likewise,the importance of culture in  the  right  diagnosis  of  diseases  should  always  be  emphasized.
OBJECTIVES: The study aimed to determine the incidence of  MOTT  in  a  tertiary  hospital  in  Manila  among  patients  suspected of having TB. 
MATERIALS AND METHODS: This is a retrospective study done at the UST Hospital, a quality-assured referral center for TB in  Manila,  with  a  TB  Directly  Observed  Short  Course  (TB-DOTS) Clinic. Laboratory records of specimens submitted for  culture  and  sensitivity  studies  for  Mycobacterium tuberculosis  (MTB)  for  which  isolates  of  MOTT  grew,  using  BACTECTM(Becton-Dickinson)  method  and  Mycobacteria  Growth  Indicator  Tube  (MGITTM),  from  January  2003  to  December 2014, were reviewed.
RESULTS: A total of 6,886 specimens were submitted for MTB culture and sensitivity studies. Results showed 157 cases of MOTT with an incidence of 2.28%. Majority of the specimens with MOTT were from pulmonary sources (85%), most common of which was from sputum. Non pulmonary sources (15%) were mostly from urine, cerebro-spinal, and gastrointestinal tract. were isolated for MOTT. These find-ings are consistent with the previous local available data. Correct identification of this organism influence eventual decisions for treatment.
CONCLUSION: The incidence of positive culture for MOTT in our institution remains to be low. However, there is an increasing trend in the number of specimens which are turning out to be positive for MOTT. A future study on the correlation with the patients' clinical profile is recommended.

Tuberculosis affecting only the appendix is exceedingly rare, and tuberculous involvement of the appendix in the presence of tuberculosis elsewhere in the body, e.g., the lung or the gastrointestinal tract, is not common. Tuberculosis of the appendix is not associated with any specific clinical features, and diagnosis is revealed only after histopathological examination. Recently, we clinically experienced a case of tubercular appendicitis on histopathologic examination after an appendectomy for acute appendicitis. This case of tubercular appendicitis is presented with a brief review of the literature.
Appendectomy ; Appendicitis ; Appendix* ; Diagnosis ; Gastrointestinal Tract ; Lung ; Tuberculosis*

Acute abdomen caused by abdominal tuberculosis is a rare manifestation, and includes bleeding of a gastric or ileal ulcer, obstruction of the small bowel by an adhesive band, perforation of the ileum, ileocolic intussusception and fistula, and mesenteric abscesses caused by necrotic lymph nodes. The clinical and radiologic features of these complicated tuberculosis may mimic other acute abdominal diseases. Although not definitive, careful evaluation of the radiologic findings of the bowel wall, mesenteric fat infiltration, and lymph node enlargement may provide useful diagnostic clues to the presence of acute abdomen due to tuberculosis.
Abdomen, Acute* ; Abscess ; Adhesives ; Fistula ; Hemorrhage ; Ileum ; Intussusception ; Lymph Nodes ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Ulcer

Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.
Adult ; Child ; Colic ; Cough ; Humans ; Intussusception ; Middle Aged ; Sputum ; Tuberculosis ; Tuberculosis, Gastrointestinal