Ileal tuberculosis diagnosed in preventive colonoscopy: Case report describing endoscopic aspects, treatment and healing
DOI:
https://doi.org/10.33448/rsd-v13i12.44723Keywords:
Colonoscopy; Ileoscopy; Intestinal Tuberculosis.Abstract
The authors' objective in presenting this case is to emphasize the importance of routine ileal intubation during colonoscopy, describe a rare case of isolated ileal tuberculosis in an asymptomatic patient, and discuss the challenge of achieving a correct etiological diagnosis when faced with atypical ileal lesions. In the described case, during a colonoscopy for colorectal cancer screening in an asymptomatic patient, ileal intubation enabled the detection of an atypical ulcerated lesion. Further investigation through biopsies, acid-fast bacilli (AFB) testing, and serological tests led to the diagnosis of isolated ileal tuberculosis. The patient underwent medical treatment, and a subsequent ileocolonoscopy confirmed healing. Although intestinal tuberculosis is relatively rare (1-3% of total tuberculosis cases), it should always be considered when ulcerated lesions are detected in the ileal region, especially in developing countries. Physicians must be vigilant and capable of recognizing and differentiating it from other conditions, as a misdiagnosis and subsequent incorrect treatment could pose serious harm to the patient. The case described illustrates the benefits of routine ileal intubation as a strong argument for the quality criteria of the examination.
References
Al-Sohaily, S., & Leong, R. W. (2008). The yield of ileoscopy at colonoscopy. Journal of Gastroenterology and Hepatology, 23(1), 4–5. https://doi.org/10.1111/j.1440-1746.2007.05236.x
Bhasin, D. K., Goenka, M. K., Dhavan, S., Dass, K., & Singh, K. (2000). Diagnostic value of ileoscopy: a report from India. Journal of Clinical Gastroenterology, 31(2), 144–146. https://doi.org/10.1097/00004836-200009000-00011
Börsch, G., & Schmidt, G. (1985). Endoscopy of the terminal ileum: Diagnostic yield in 400 consecutive examinations. Diseases of the Colon & Rectum, 28(6), 499-501.
Coremans, G., Rutgeerts, P., Geboes, K., Van den Oord, J., Ponette, E., & Vantrappen, G. (1984). The value of ileoscopy with biopsy in the diagnosis of intestinal Crohn's disease. Gastrointestinal Endoscopy, 30(3), 167–172. https://doi.org/10.1016/s0016-5107(84)72358-3
Jensen, M. D., Nathan, T., Rafaelsen, S. R., & Kjeldsen, J. (2012). Ileoscopy reduces the need for small bowel imaging in suspected Crohn's disease. Danish Medical Journal, 59(9), A4491.
Kedia, S., Das, P., Madhusudhan, K. S., Dattagupta, S., Sharma, R., Sahni, P., Makharia, G., & Ahuja, V. (2019). Differentiating Crohn's disease from intestinal tuberculosis. World Journal of Gastroenterology, 25(4), 418–432. https://doi.org/10.3748/wjg.v25.i4.418
Leung, V. K., Tang, W. L., Cheung, C. H., & Lai, M. S. (2001). Importance of ileoscopy during colonoscopy for the early diagnosis of ileal tuberculosis: report of two cases. Gastrointestinal Endoscopy, 53(7), 813–815. https://doi.org/10.1067/mge.2001.114954
Lewis, B. S. (2000). Ileoscopy should be part of standard colonoscopy: a comparison of radiographic and endoscopic evaluation of the ileum. Journal of Clinical Gastroenterology, 31(2), 103–104. https://doi.org/10.1097/00004836-200009000-00002
Li, X., Liu, X., Zou, Y., Ouyang, C., Wu, X., Zhou, M., ... Lu, F. (2011). Predictors of clinical and endoscopic findings in differentiating Crohn's disease from intestinal tuberculosis. Digestive Diseases and Sciences, 56(1), 188-196. https://doi.org/10.1007/s10620-010-1231-4
Mari, A., Khoury, T., Mahamid, M., Akram, S., Kopelman, Y., & Abu Baker, F. (2020). The Yield of Ileoscopy: Does Indication Matter? The Israel Medical Association Journal: IMAJ, 11(22), 684–687.
Maulahela, H., Simadibrata, M., Nelwan, E. J., Rahadiani, N., Renesteen, E., Suwarti, S. W. T., & Anggraini, Y. W. (2022). Recent advances in the diagnosis of intestinal tuberculosis. BMC Gastroenterology, 22(1), 89. https://doi.org/10.1186/s12876-022-02171-7
Mendes, W. B., Batista, C. A. M., Lima, H. A. de., Leite, G. F., Paula, J. F. de., Porto, W. B., ... Magno Jr, C. (2009). Tuberculose intestinal como causa de obstrução intestinal: relato de caso e revisão de literatura. Revista Brasileira de Coloproctologia, 29(4), 489–492. https://doi.org/10.1590/S0101-98802009000400009
Misra, S. P., Misra, V., & Dwivedi, M. (2007). Ileoscopy in patients with ileocolonic tuberculosis. World Journal of Gastroenterology, 13(11), 1723-1727. https://doi.org/10.3748/wjg.v13.i11.1723
Obeidat, A. E., Namiki, T., & Murakami, T. T. (2021). More Than Just a Polyp: Diagnosis of Tuberculosis From a Screening Colonoscopy. Cureus, 13(2), e13216. https://doi.org/10.7759/cureus.13216
Oñate-Ocaña, L. F., & Pérez-Díaz, L. (2022). Intestinal Tuberculosis. The New England Journal of Medicine, 386(13), e30. https://doi.org/10.1056/NEJMicm2114345
Rubio, T., Gaztelu, M. T., Calvo, A., Repiso, M., Sarasíbar, H., Bermejo, F. J., et al. (2005). Tuberculosis abdominal. Anales Sis San Navarra, 28(2), 257-260.
Seo, K. I., & Moon, W. (2016). Endoscopic Bamboo Joint-like Appearance of the Stomach in Crohn's Disease. Clinical Endoscopy, 49, 370-375.
Sultan, S., & Mitchell, R. M. (2004). The importance of ileoscopy in patients with suspected small bowel disease. European Journal of Gastroenterology & Hepatology, 16(3), 359. https://doi.org/10.1097/00042737-200403000-00018
Tanoglu, A., Erdem, H., Friedland, J. S., Almajid, F. M., Batirel, A., Kulzhanova, S., ... Ormeci, N. (2020). Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study. European Journal of Clinical Microbiology & Infectious Diseases, 39(3), 493–500. https://doi.org/10.1007/s10096-019-03749-y
Wijewantha, H. S., de Silva, A. P., Niriella, M. A., Wijesinghe, N., Waraketiya, P., Kumarasena, R. S., ... de Silva, H. J. (2014). Usefulness of Routine Terminal Ileoscopy and Biopsy during Colonoscopy in a Tropical Setting: A Retrospective Record-Based Study. Gastroenterology Research and Practice, 2014, 343849. https://doi.org/10.1155/2014/343849
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Eric Arcanjo Bringel; Robert William de Azevedo Bringel; Júlia Oliveira de Assis
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.