Colonic Tuberculosis Diagnosedby Colonoscopic Biopsy, Report of a Case Yasumasa Hatada 1 , Akihiro Munakata 1 , Tadashi Aisawa 2 1The First Department of Internal Medicine, Hirosaki University, School of Medicine 2Division of Endoscopy, Aomori Prefectural Central Hospital pp.649-652
Published Date 1986/6/25
DOI https://doi.org/10.11477/mf.1403110355
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 A 43-year-old man was admitted to our hospital because of bloody stool. Physical examination was unremarkable.Laboratory studies revealed an erythrocyte sedimentation rate of 14mm/hr and tuberculin test yielded 46×43mm in erythelna.He had no history of pulmonary tuberculosis and chest roentogenogram was negative.

 Barium enema x-ray study demonstrated annular stricture of the ascending colon with no shortening. Endoscopic examination showed a tumor with ulceration suggesting Borrmann type 2 colon cancer and three polyps in the rectosigmoid colon. Biopsy specimens, however, revealed caseating granuloma result-ing in the diagnosis of colonic tuberculosis.Repeated fecal cultures were all negative for acid-fast baccilli. The antituberculous drugs (INH, RFP&PAS) were administered.  After the treatment, annular stricture with ulceration of the ascending colon has improved into scars, followed by the formation of inflammatory polyps.  In this case it was difficult to differentiate colonic tuberculosis from cancer because of the segmental hypertrophic form and colonoscopic biopsy was useful in reaching the final diagnosis.

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