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Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

OBJECTIVES: Tuberculosis (TB) is still common in many countries and there has been a resurgence of TB in the developed nations. Although small bowel is the most commonly affected gastrointestinal organ, increasing numbers of cases are being described with colon TB. There are limited prospective stud...

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Autores principales: Mukewar, Saurabh, Mukewar, Shrikant, Ravi, Raghvendra, Prasad, Arun, S Dua, Kulwinder
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491534/
https://www.ncbi.nlm.nih.gov/pubmed/23238066
http://dx.doi.org/10.1038/ctg.2012.19
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author Mukewar, Saurabh
Mukewar, Shrikant
Ravi, Raghvendra
Prasad, Arun
S Dua, Kulwinder
author_facet Mukewar, Saurabh
Mukewar, Shrikant
Ravi, Raghvendra
Prasad, Arun
S Dua, Kulwinder
author_sort Mukewar, Saurabh
collection PubMed
description OBJECTIVES: Tuberculosis (TB) is still common in many countries and there has been a resurgence of TB in the developed nations. Although small bowel is the most commonly affected gastrointestinal organ, increasing numbers of cases are being described with colon TB. There are limited prospective studies looking at the outcomes of colon lesions, especially after anti-TB treatment. Our aim was to evaluate the endoscopic features of TB of the colon and to prospectively follow up the endoscopic response of colon lesions to anti-TB treatment. METHODS: From October 2004 to December 2010 consecutive patients presenting with colon TB to one tertiary care center in India were enrolled. Demographic, clinical data, and lesions identified on colonoscopy were recorded. Anti-TB treatment was started and follow-up colonoscopy was performed within 4 weeks after completion of anti-TB treatment. Post-treatment endoscopic features and clinical outcomes were noted. RESULTS: Sixty-nine consecutive patients with colon TB were enrolled (mean age 39.3±14.8 years; male 45, female 24). Presenting clinical features included abdominal pain 80.6%, weight loss 74.6%, fever 40.3%, diarrhea/constipation 25.4%, diarrhea 16.4%, blood per rectum 11.9%, abdominal tenderness 37.3%, abdominal mass 13.4%, and lymphadenopathy 1.5%. Macroscopic lesions on endoscopy were predominantly right-sided (cecum and ascending colon) and primarily ulcers (ulcers 88.0%, nodules 50.7%, luminal narrowing 44.8%, polypoid lesion 10.4%). Majority of the ulcers (87.2%), nodules (84.6%), polypoid lesions (85.7%), luminal narrowing (76.2%), and ileo-cecal valve deformities (76.5%) resolved with anti-TB treatment. CONCLUSIONS: TB of the colon predominantly affects the cecum and the ascending colon. Ulceration, nodularity, and stricture are the prominent endoscopic findings. Majority of the lesions heal with anti-TB treatment.
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spelling pubmed-34915342012-11-07 Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment Mukewar, Saurabh Mukewar, Shrikant Ravi, Raghvendra Prasad, Arun S Dua, Kulwinder Clin Transl Gastroenterol Colon/Small Bowel OBJECTIVES: Tuberculosis (TB) is still common in many countries and there has been a resurgence of TB in the developed nations. Although small bowel is the most commonly affected gastrointestinal organ, increasing numbers of cases are being described with colon TB. There are limited prospective studies looking at the outcomes of colon lesions, especially after anti-TB treatment. Our aim was to evaluate the endoscopic features of TB of the colon and to prospectively follow up the endoscopic response of colon lesions to anti-TB treatment. METHODS: From October 2004 to December 2010 consecutive patients presenting with colon TB to one tertiary care center in India were enrolled. Demographic, clinical data, and lesions identified on colonoscopy were recorded. Anti-TB treatment was started and follow-up colonoscopy was performed within 4 weeks after completion of anti-TB treatment. Post-treatment endoscopic features and clinical outcomes were noted. RESULTS: Sixty-nine consecutive patients with colon TB were enrolled (mean age 39.3±14.8 years; male 45, female 24). Presenting clinical features included abdominal pain 80.6%, weight loss 74.6%, fever 40.3%, diarrhea/constipation 25.4%, diarrhea 16.4%, blood per rectum 11.9%, abdominal tenderness 37.3%, abdominal mass 13.4%, and lymphadenopathy 1.5%. Macroscopic lesions on endoscopy were predominantly right-sided (cecum and ascending colon) and primarily ulcers (ulcers 88.0%, nodules 50.7%, luminal narrowing 44.8%, polypoid lesion 10.4%). Majority of the ulcers (87.2%), nodules (84.6%), polypoid lesions (85.7%), luminal narrowing (76.2%), and ileo-cecal valve deformities (76.5%) resolved with anti-TB treatment. CONCLUSIONS: TB of the colon predominantly affects the cecum and the ascending colon. Ulceration, nodularity, and stricture are the prominent endoscopic findings. Majority of the lesions heal with anti-TB treatment. Nature Publishing Group 2012-10 2012-10-11 /pmc/articles/PMC3491534/ /pubmed/23238066 http://dx.doi.org/10.1038/ctg.2012.19 Text en Copyright © 2012 American College of Gastroenterology http://creativecommons.org/licenses/by-nc-nd/3.0/ This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Colon/Small Bowel
Mukewar, Saurabh
Mukewar, Shrikant
Ravi, Raghvendra
Prasad, Arun
S Dua, Kulwinder
Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title_full Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title_fullStr Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title_full_unstemmed Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title_short Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment
title_sort colon tuberculosis: endoscopic features and prospective endoscopic follow-up after anti-tuberculosis treatment
topic Colon/Small Bowel
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491534/
https://www.ncbi.nlm.nih.gov/pubmed/23238066
http://dx.doi.org/10.1038/ctg.2012.19
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