Diagnostic and Therapeutic Approach in Intestinal Tuberculosis
Abstract: Tuberculosis was
still a global health problem. Beside lung, tuberculosis also manifest in other
organs, one among them is in abdominal
organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms
so that its diagnostic procedure was not rarely inconclusive. We reported a 24
years old woman with chief complain of worsening abdominal pain in all region,
accompanied by nausea, vomiting, bloating, and
absent bowel movement. She also had a fresh bloody stool. She had an
active pulmonary tuberculosis on initiation phase treatment. Physical
examination suggest a bowel obstruction sign with distended abdomen and
increase bowel sound. Colonoscopy procedure findings was a mass that obstruct
bowel lumen in ileocaecal region, suggest for malignancy similar to
computerized tomography (CT) scan result, but pathlogic result showed an active
colitis without any sign of malignancy. Because of its contradiction, the
second colonoscopy was performed and concluded as intestinal tuberculosis,
matched with second pathologic examination. Although polymerase chain reaction
(PCR) tuberculosis (TB) showed a negative result, a further clinical judgement
concluded this as an intestinal tuberculosis case. Patient was finally treated
as intestinal tuberculosis with first-line antituberculosis drugs and planned
to have colonoscopy evaluation. After general condition was good and
obstructive ileus sign was relieved, patient planned for outpatient care.
Keywords: intestinal
tuberculosis; colonoscopy; abdominal pain; diagnosis; therapy
Author: Tri Hapsoro Guno,
Barry A Putra, Telly Kamelia, Dadang Makmun
Journal Code: jpkedokterangg160418
