A clinical study on intestinal tuberculosis.

Lee, Hong Sic; Kim, Kyoung Soo; Choi, Hack Bung

Original Article

Journal of the Korean Academy of Family Medicine 1991;12(3):46-53.
Published online March 1, 1991.

A clinical study on intestinal tuberculosis.

Hong Sic Lee, Kyoung Soo Kim, Hack Bung Choi

장 결핵의 임상적 고찰

이홍식, 최학붕, 김경수

부천대성병원 가정의학과

Abstract

The tuberculosis involvement of alimentary tract was remarkably low in morbidity, pulmonary tuberculosis with the use of antituberculosis agents since 1950. But prevalence of tuberculosis is high in Korea and the dignosis of alimentary tract tuberculosis is difficult.
These 22 cases of intestinal tuberculosis, selected according to the Bockus diagnostic criteria, was managed in Buchun Daesung Hospital during the past 6 years from 1984 to May 1989.
The results are as follows :
1. The sex ratio is 1:1.4 in favor of female. The average age of all patients is 31 years with its range from 3 to 68 and intestinal tuberculosis is most frequent in 20-39 age group.
2. Clinical symptom onset before admission was common below the 1st year(92%) and most common in 2 to 4th weeks (37%).
3. The frequent symptoms are abdominal pain, nausea and vomiting, diarrhea, and weight loss.
4. The common physical signs are tenderness, palpable abdominal mass, distention and weight loss.
5. The dignosis was made by history, clinical manifestation, physical examination, radiological examination. and laboratory data. Most of them were confirmed by pathlogical examination, after surgery.
6. The involvement of alimentary tract is multiple or diffuse in 85% and most frequently in ileocecal region.
7. The common complications are intestinal obstruction, intestinal perforation and fistula.
8. The case fatality was 9 percent. There was 2 cases of mortality which was sepsis and severe obstruction.
9. Post-operative diagnosis of the patient with presumptive diagnosis of intestinal Tbc was unknown intestinal obstruction, colon cancer, intestinal Tbc, peptic ulcer perforation, periappendiceal abscess. The rate of misdiagnosis was 65 percent.