The Clinical Diagnosis And Prognosis Of 21 Cases Of Intestinal Tuberculosis

Objective:To investigate the clinical features and prognosis of intestinal tuberculosis and learn how to improve the rate of correct diagnosis.Methods:The clinical data of 21 patients with intestinal tuberculosis were analyzed retrospectively and related literatures were discussed.Results:There were 7 cases of male,14 cases of female in total 21 cases; aged between 19 and 88 years old with an average age 47.8 years old. Most of the patients graduated from or under from Middle School (85.7%), and they are mainly farmers (42.8%). Common symptoms included abdominal pain (66.7%), weight loss (47.6%), abdominal distention, and diarrhea, little manifested as extra-intestinal lesions. The location of pain was uncertainty and most lies in inferior belly. The physical examination of intestinal tuberculosis was non-specific, most Signs in abdominal tenderness (66.7), and were often touched on superficial lymph nodes (28.6%). Most laboratory tests in such patients were abnormal, such as erythrocyte sedimentation rate elevated (80.9%), anemia (61.9%), PPD test positive(57.0%), CRP increased (57.0%) and hypoproteinemia(47.6%) and serum CA125 (47.6%) also elevated, which can tip intestinal tuberculosis. The chest X-ray (64.7%) can be used for screening of tuberculosis, CT scans easy to find location of lesions (86.7%), but its specificity is not high, most indicated thickened bowel wall (73.4%) or a lump (13.3%). Colonoscopy or capsule endoscopy indicated signify ulcer (73.3%), and the lesions were located at right colon or ileum. Granulomatous inflammation (52.6%) can be found in Histopathological or acid-fast bacilli were found (36.8%). After treatment,1 patient was removed because she could not tolerate the anti-TB drugs, in the other patients:57.1% of abdominal pain was complete remission,66.7%weight increase,85.7%of abdominal distension disappeared,71.4%of the diarrhea disappeared, the body temperature of all patients tolerated the treatment returned to normal in all patients.Conclusion:Intestinal TB is a common disease, but its diagnosis and differential diagnosis was rather difficult, and the identification between the two diseases is particularly difficult. When diagnosed of tuberculosis, we should make up of a comprehensive decision including the history of TB or TB exposure, clinical history, signs, and colonoscopy or surgical pathology, chest X-ray, CT scans etc., but when making a diagnosis, we mainly rely on colonoscopy or surgery pathology. So we can use chest X-ray for screening for tuberculosis; use abdominal CT for finding the location of lesion. Unless there are serious complications, the prognosis of patients with intestinal tuberculosis is generally good.