The value of colonoscopy in the diagnosis of lleo-caecal tuberculosis

Intestinal tuberculosis: findings on double-contrast barium enema

Seven cases of intestinal tuberculosis in an active stage were studied by the double-contrast barium enema (DCBE) method. Formerly, diagnosis of intestinal tuberculosis in the early stage by single-contrast barium enema (SCBE) and barium meals was based on functional phenomena, such as spasm and hypermotility of the ileocecal region. Presently, this can be better accomplished by DCBE. DCBE enables the detection of shallow ulcers with their characteristic elevated margins. These ulcers are frequently slim and transversally oriented. Confluence of ulcers may create whole girdle ulcers or affect entire segments. In more advanced stages, characteristic deformities, also evident by SCBE, such as symmetrical annular stenoses, shortening, retraction, pouch formation, and the frequently observed pathology of the ileocecal valve and the cecal region, acquire a new dimension with DCBE.

The value of colonoscopy in schistosomal, tuberculous, and amebic colitis. Two-year experience

Forty-six patients were diagnosed as having schistosomal, tuberculous, or amebic colitis over a two-year period using colonoscopy and biopsy. Both schistosomal and tuberculous colitis could be diagnosed by characteristic endoscopic and histologic features in the majority of cases. Colonoscopy provided the added advantage of endoscopic polypectomy at the diagnostic session itself. The yield of granulomas in tuberculous lesions was 100 percent, although acid-fast bacilli could not be recovered from any. The endoscopic picture of amebic colitis often resembles that of inflammatory bowel disease; hence endoscopic biopsies are of paramount importance in establishing a correct diagnosis, especially in developing countries where both diseases exist with considerable frequency.

Colonoscopy in the diagnosis of abdominal tuberculosis in children

Childhood abdominal tuberculosis has protean manifestations and remains a difficult diagnosis problem, often requiring surgery for pathological confirmation. Colonoscopy, however, can now be performed with safety in children and appears to offer a new and better alternative to surgery. An earlier experience confirmed its value in the management of ileocaecal tuberculosis as it provided histological proof and bacteriological information to guide chemotherapy, avoiding the need for anaesthesia and laparotomy. However, colonoscopy hasn't been helpful in the diagnosis of the 'exudative' type of abdominal tuberculosis.