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Chaudhary P, Nagpal A, Padala SB, Mukund M, Bansal LK, Lal R. Rectal tuberculosis: A systematic review. Indian J Tuberc 2022; 69:268-276. [PMID: 35760476 DOI: 10.1016/j.ijtb.2021.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/30/2021] [Accepted: 06/09/2021] [Indexed: 06/15/2023]
Abstract
Rectal tuberculosis is an uncommon entity. It has unique epidemiological features, specific medical treatment and surgery is rarely indicated. The first case of rectal tuberculosis was reported in 1957. Delayed diagnosis is common. Patients who develop rectal tuberculosis have been reported to have some risk factors or associated comorbid conditions or pathologies with some form of abnormal host-defence mechanism such as acquired immunodeficiency syndrome, complement deficiency. Rectal tuberculosis has been reported to be more common in females as compared to males. Haematochezia is the most common presenting symptom. The definite diagnosis requires demonstration of Mycobacterium tuberculosis bacillus on histopathologic examination. Once a correct diagnosis has been made, rectal tuberculosis is curable with antituberculous treatment. Surgery is indicated for diagnostic dilemmas, non-responsive disease and complications. The authors encountered 3 cases in the last 10 years. The aim of this study is to provide our data on this rare disease and to review the reported literature comprehensively so as to provide guidelines for diagnosis and management.
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Affiliation(s)
- Poras Chaudhary
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India.
| | - Ashutosh Nagpal
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Sam B Padala
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Mangarai Mukund
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Lalit K Bansal
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Romesh Lal
- Department of General Surgery, Lady Hardinge Medical College, Dr Ram Manohar Lohia Hospital, New Delhi, India
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2
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Ionescu S, Nicolescu AC, Madge OL, Marincas M, Radu M, Simion L. Differential Diagnosis of Abdominal Tuberculosis in the Adult-Literature Review. Diagnostics (Basel) 2021; 11:2362. [PMID: 34943598 PMCID: PMC8700228 DOI: 10.3390/diagnostics11122362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.
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Affiliation(s)
- Sinziana Ionescu
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Octavia Luciana Madge
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
| | - Marian Marincas
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Madalina Radu
- Pathology Department, Bucharest Oncology Institute, 022328 Bucharest, Romania;
| | - Laurentiu Simion
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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3
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Manoria P, Singhai A, Gulwani HV. Isolated Rectal Tuberculosis in Immunocompetent Host. J Glob Infect Dis 2021; 13:148-150. [PMID: 34703157 PMCID: PMC8491808 DOI: 10.4103/jgid.jgid_318_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 11/15/2022] Open
Abstract
Abdominal tuberculosis (TB) is the sixth most common site for extrapulmonary TB. Ileocecal region is the most common site for it, and its incidence reduces as we move proximally and distally from it. Isolated rectal TB in an immunocompetent person is very rare, and it usually mimics as rectal carcinoma. The yield of endoscopic biopsies for granuloma is low due to submucosal location of these lesions, and mostly, they are diagnosed after surgical intervention. We report a case of isolated rectal TB in a middle-aged female who present with chronic diarrhea and was diagnosed by the presence of epithelioid cells forming granulomas and acid-fast bacilli in rectal biopsy.
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Affiliation(s)
- Piyush Manoria
- Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
| | - Abhishek Singhai
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Hanni V Gulwani
- Department of Pathology, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
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4
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Malikowski T, Mahmood M, Smyrk T, Raffals L, Nehra V. Tuberculosis of the gastrointestinal tract and associated viscera. J Clin Tuberc Other Mycobact Dis 2018; 12:1-8. [PMID: 31720391 PMCID: PMC6830173 DOI: 10.1016/j.jctube.2018.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 03/10/2018] [Accepted: 04/09/2018] [Indexed: 02/07/2023] Open
Abstract
Tuberculosis involvement of the gastrointestinal tract, peritoneum, and associated viscera is an uncommon but well described entity. While peritoneal tuberculosis and tuberculous enteritis are more common, involvement of the esophagus, stomach, colon, rectum, anus, liver, bile ducts, gallbladder, and pancreas can occur. Diagnosis is challenging as cases often mimic neoplasm or inflammatory bowel disease. In this review we outline the pathogenesis, clinical presentation, diagnostic testing, and treatment strategies pertaining to such cases.
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Affiliation(s)
- Thomas Malikowski
- Department of Internal Medicine, Mayo Clinic 200 First St. SW, Rochester, MN 55905 507-284-2511, United States
| | - Maryam Mahmood
- Division of Infectious Diseases, Mayo Clinic 200 First St. SW, Rochester, MN 55905 507-284-2511, United States
| | - Thomas Smyrk
- Department of Anatomic Pathology, Mayo Clinic 200 First St. SW, Rochester, MN 55905 507-284-2511, United States
| | - Laura Raffals
- Division of Gastroenterology and Hepatology, Mayo Clinic 200 First St. SW, Rochester, MN 55905 507-284-2511, United States
| | - Vandana Nehra
- Division of Gastroenterology and Hepatology, Mayo Clinic 200 First St. SW, Rochester, MN 55905 507-284-2511, United States
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5
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Wang WL, Chang IW, Lee CT. An Unusual Rectal Mass. Gastroenterology 2018; 154:e10-e11. [PMID: 28712754 DOI: 10.1053/j.gastro.2017.05.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 12/02/2022]
Affiliation(s)
- Wen-Lun Wang
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - I-Wei Chang
- Department of Pathology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Ching-Tai Lee
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
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6
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Zeidman JA, Shellito PC, Davis BT, Zukerberg LR. CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL. Case 25-2016. A 33-Year-Old Man with Rectal Pain and Bleeding. N Engl J Med 2016; 375:676-82. [PMID: 27532834 DOI: 10.1056/nejmcpc1602815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jessica A Zeidman
- From the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Massachusetts General Hospital, and the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Harvard Medical School - both in Boston
| | - Paul C Shellito
- From the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Massachusetts General Hospital, and the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Harvard Medical School - both in Boston
| | - Benjamin T Davis
- From the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Massachusetts General Hospital, and the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Harvard Medical School - both in Boston
| | - Lawrence R Zukerberg
- From the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Massachusetts General Hospital, and the Departments of Medicine (J.A.Z., B.T.D.), Surgery (P.C.S.), and Pathology (L.R.Z.), Harvard Medical School - both in Boston
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7
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Singh J, Puri AS, Sachdeva S, Sakhuja P, Arivarasan K. Rectal tuberculosis after infliximab therapy despite negative screening for latent tuberculosis in a patient with ulcerative colitis. Intest Res 2016; 14:183-6. [PMID: 27175120 PMCID: PMC4863053 DOI: 10.5217/ir.2016.14.2.183] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 11/05/2022] Open
Abstract
Tumor necrosis factor-α inhibitors are now considered as standard therapy for patients with severe inflammatory bowel disease who do not respond to corticosteroids, but they carry a definite risk of reactivation of tuberculosis. We present a case in which a patient with inflammatory bowel disease developed a de novo tuberculosis infection after the start of anti-tumor necrosis factor-α treatment despite showing negative results in tuberculosis screening. Although there are many case reports of pleural, lymph nodal and disseminated tuberculosis following infliximab therapy, we present the first case report of rectal tuberculosis following infliximab therapy.
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Affiliation(s)
- Jatinderpal Singh
- Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Amarender S Puri
- Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Sanjeev Sachdeva
- Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Puja Sakhuja
- Department of Pathology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Kulandaivelu Arivarasan
- Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
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8
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Baylon SC, de Barros MDSV, Christiano CG, Lovisolo SM, Rosa VMPS. Rectal tuberculosis in an HIV-infected patient: case report. AUTOPSY AND CASE REPORTS 2014; 4:65-69. [PMID: 28573121 PMCID: PMC5444401 DOI: 10.4322/acr.2014.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 08/19/2014] [Indexed: 11/23/2022] Open
Abstract
The gastrointestinal (GI) tract has been increasingly affected by tuberculosis, especially in immunocompromised patients. Although strict rectal involvement is rare, the GI site mostly affected is the ileocecal region. Thus, tuberculosis should always be considered in the differential diagnosis of perianal and rectal lesions, and more so in patients infected by the HIV virus. The authors report the case of a 32-year-old man presenting a long-term history of fever, night sweats, weight loss, bloody diarrhea, fecal incontinence, tenesmus, and rectal pain. HIV serology was positive. The patient underwent anoscopy and biopsy, which disclosed the diagnosis of rectal tuberculosis. Thus the patient was referred to an outpatient clinic to follow the standard treatment.
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Affiliation(s)
- Simone Cristina Baylon
- Endoscopy Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | | | - Silvana Maria Lovisolo
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
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9
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Perianal tuberculosis: a case report and a review of the literature. Case Rep Infect Dis 2012; 2012:852763. [PMID: 23346433 PMCID: PMC3546444 DOI: 10.1155/2012/852763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 12/06/2012] [Indexed: 02/06/2023] Open
Abstract
Extra pulmonary tuberculosis accounts for less than 15% of all cases of tuberculosis whereas the Intestinal one constitutes less than 1% of the extrapulmonary forms of the disease. The lesions of abdominal organs are more common while they rarely occur in the anoperineal area for the spread of the disease to the anus is extremely rare. We report a case of a 37-year-old male patient with large bilateral infected perianal tubercular ulcerations as well as pulmonary and peritoneal tuberculosis. The treatment was both surgical and medical and the therapy lasted for seven months. After six months from the beginning of the treatment, the lesion had totally disappeared and there is still no recurrence after one year of followup. Tuberculosis should generally be taken into consideration in the differential diagnosis of the ulcerative lesions of the anal and perianal regions for these lesions do occur in the said areas despite their rarity. The treatment is usually both surgical and medical so as to get excellent results.
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10
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Sinha R, Rajesh A, Rawat S, Rajiah P, Ramachandran I. Infections and infestations of the gastrointestinal tract. Part 1: bacterial, viral and fungal infections. Clin Radiol 2012; 67:484-94. [PMID: 22257535 DOI: 10.1016/j.crad.2011.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 09/23/2011] [Accepted: 10/12/2011] [Indexed: 01/03/2023]
Abstract
The purpose of this article is to review the imaging findings of various infections affecting the gastrointestinal tract. Barium examinations, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography all play an important role in the diagnostic workup of gastrointestinal tract infections. Knowledge of differential diagnosis, sites of involvement, and typical imaging features of different infections can help in accurate diagnosis and guide treatment.
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Affiliation(s)
- R Sinha
- Department of Clinical Radiology, South Warwickshire NHS Foundation Trust, Warwick, UK.
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11
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Gierthmühlen M, Laiffer G, Viehl CT, Savic S, Bremerich J, Mueller C, Christ M. [No ordinary anal fistula...]. Internist (Berl) 2008; 49:490, 492-4. [PMID: 18320154 DOI: 10.1007/s00108-008-2063-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We present the case of a 63 year-old male Swiss patient with chronic diarrhea, mucous anal discharge, anal fistula, chronic anal ulceration and history of tuberculosis 56 years ago. Imaging and endoscopy was highly suspicious for Crohn's Disease, but histology and culture for M. tuberculosis proved tuberculous proctitis with perianal involvement and fistulation. The consideration of extrapulmonal tuberculosis with its various manifestations is crucial for the investigation of chronic abdominal complaints in order to avoid serious consequences of tuberculosis treated with immunosuppressive therapy.
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Affiliation(s)
- M Gierthmühlen
- Medizinische Klinik, Universitätsspital, Petersgraben 4, 4031, Basel, Switzerland
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12
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Martínez Ares D, Longueira Suárez R, Martín-Granizo Barrenechea I, Díaz Pedreira JA, Santiago Freijanes P, Pallarés Peral A. Tuberculosis rectal que simula un cáncer de recto. GASTROENTEROLOGIA Y HEPATOLOGIA 2008; 31:46-7. [DOI: 10.1157/13114585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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13
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Abstract
OBJECTIVE Reports suggest that the rates of tuberculosis (TB) continue to rise in the UK and throughout the world. The spread of the disease is aided by poverty, overcrowding, co-infection with human immunodeficiency virus and drug resistance. Consistent with the overall trend, intra-abdominal and gastrointestinal (GI) TB rates are rising. Tuberculosis is a treatable disease, whether occurring in the lungs or at extra-pulmonary sites but the nonspecific features of the disease result in difficulty in establishing a diagnosis. In this report, we have concentrated on the benefits and potential pitfalls of diagnostic methods. METHOD A literature review was performed using the National Library of Medicine's Pubmed Database using the keywords diagnosis, management, abdominal and GI TB. RESULTS Abdominal TB presents a particular challenge, as the diverse features of the disease do not readily suggest a particular diagnosis and diagnostic delays lead to significant morbidity and mortality. A number of investigative methods have been used to aid in the diagnosis of abdominal and GI TB. CONCLUSION The nonspecific presentation of abdominal and GI TB present challenges in the diagnosis of this increasingly common disease. A high index of suspicion is an important factor in early diagnosis. After a diagnosis has been established, prompt initiation of treatment helps prevent morbidity and mortality.
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Affiliation(s)
- S Rasheed
- St Mark's Hospital, Harrow, Middlesex, UK
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14
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Alam I, Shanoon D, Alhamdani A, Boyd A, Griffiths AP, Baxter JN. Severe proctitis, perforation, and fatal rectal bleeding secondary to cytomegalovirus in an immunocompetent patient: report of a case. Surg Today 2007; 37:66-9. [PMID: 17186350 PMCID: PMC7102328 DOI: 10.1007/s00595-006-3335-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Accepted: 07/25/2006] [Indexed: 01/30/2023]
Abstract
Cytomegalovirus (CMV) infection is associated with significant morbidity and mortality in immunocompromised patients. In immunocompetent individuals, the infection is usually subclinical but it can sometimes be life threatening. We describe a case of fatal CMV proctitis in a 71-year-old man following an Ivor-Lewis esophagectomy. After surgery he developed renal failure, methicillin-resistant Staphylococcus aureus pneumonia, and acute respiratory distress syndrome. He recovered but developed melena and massive fresh rectal bleeding. Sigmoidoscopy revealed severe proctitis and a biopsy was consistent with ischemia. Despite undergoing a proctectomy he continued to bleed and died despite every effort. The final histological examination of the rectum revealed a CMV infection.
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Affiliation(s)
- Imran Alam
- Department of Surgery, Morriston Hospital, Swansea, SA6 6NL, UK
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15
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Mathew S. Anal tuberculosis: report of a case and review of literature. Int J Surg 2006; 6:e36-9. [PMID: 19059132 DOI: 10.1016/j.ijsu.2006.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2006] [Revised: 11/24/2006] [Accepted: 11/27/2006] [Indexed: 12/17/2022]
Abstract
PURPOSE A case of anal tuberculosis with a perianal growth and anal ulceration is presented. The clinical features and the diagnostic problems along with increasing incidence of new cases of tuberculosis are discussed. METHODS The diagnosis, management and outcome of an adult male patient, who presented with perianal lesions are described. RESULTS On a four drug anti-tuberculous regimen, the symptoms improved and perianal lesions healed. CONCLUSION Anal tuberculosis although extremely rare, can be manifested in various forms. A high index of suspicion of tuberculosis should be borne in mind in all cases of perianal lesions with vague etiology or with diagnostic problems, which should be confirmed by histological and bacteriological analysis and treated specifically.
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Affiliation(s)
- Soniya Mathew
- Queen's Medical Centre, Department of Emergency Medicine, Nottingham NG7 2UH, UK
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Abstract
The epidemic of acquired immunodeficiency syndrome has caused a worldwide resurgence of tuberculosis. A case of acute tuberculosis with anorectal involvement presenting at an urban American hospital is discussed. Although anorectal involvement by tuberculosis is not uncommon, the diagnosis is usually initially missed.
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Affiliation(s)
- L G Koniaris
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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Chung CK, Meng WC, Thomas TM, Chan MC, Lau Y, Yip AW. Rectal stricture due to tuberculosis. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:828-9. [PMID: 10553977 DOI: 10.1046/j.1440-1622.1999.01707.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C K Chung
- Department of Surgery, Kwong Wah Hospital, Kowloon, Hong Kong
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18
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Abstract
Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality.
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Affiliation(s)
- V K Kapoor
- Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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