Tuberculosis terminal ileitis:A forgotten entity mimicking Crohn's disease

作     者：Simona Gurzu Calin Molnar Anca Otilia Contac Annamaria Fetyko Ioan Jung 

作者机构：Department of PathologyUniversity of Medicine and Pharmacy 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2016年第4卷第9期

页      面：273-280页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Ileitis Autopsy Ileotyphlitis Crohn’s disease Tuberculosis Inflammatory bowel disease Ischemic colitis 

摘      要：Intestinal tuberculosis(TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn s disease(CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed. The patient s status deteriorated and he died 4 d after the surgical intervention. At the autopsy, TB ileotyphlitis was discovered. The clinical criteria of the differential diagnosis between intestinal TB and CD are not very well established. Despite the large amount of published articles on this subject, only 50 papers present new data regarding intestinal TB. Based on these studies and our experience, we present an update focused on the differential diagnosis and therapy of intestinal TB. We highlight the importance of considering intestinal TB as a differential diagnosis for inflammatory bowel disease. Despite the modern techniques of diagnosis and therapy, the fulminant evolution of TB can still lead to a patient s death.