       Document 0409
 DOCN  M9630409
 TI    Isolated sigmoid tuberculosis. Report of a case.
 DT    9603
 AU    Horvath KD; Whelan RL; Weinstein S; Basner AL; Staugaitis SM; Greenebaum
       E; Department of Surgery, College of Physicians and Surgeons,; Columbia
       University, New York, New York, USA.
 SO    Dis Colon Rectum. 1995 Dec;38(12):1327-30. Unique Identifier : AIDSLINE
       MED/96101566
 AB    PURPOSE: To heighten awareness of colonic tuberculosis (TB) as a once
       rare disease that is undergoing a resurgence in the United States.
       METHODS: Report of a case of isolated sigmoid tuberculosis with a brief
       literature review of the topic. RESULTS: TB can no longer be considered
       a rare disease in the United States because, in part, of the acquired
       immunodeficiency syndrome epidemic and because, in part, of increased
       immigration and lack of containment. The signs and symptoms of colonic
       TB are nonspecific; therefore, a high index of suspicion must be
       maintained. Only 20 percent of patients will have associated active
       pulmonary TB. Colonoscopy with multiple biopsies at ulcer margins should
       be performed for diagnosis. Tissue should be sent for routine histology
       and culture and smeared for direct visualization of acid-fast bacilli.
       If colonic TB is suspected, empiric treatment is warranted, despite
       negative histology, smear, and culture results. Patients will usually
       show a dramatic response in one to two weeks. Treatment is solely
       medical, and all patients should receive a full course of
       antituberculous chemotherapy. Exploratory laparotomy is necessary if
       diagnosis is in doubt, when there is concern about a neoplasm, or for
       complications including perforation, obstruction, hemorrhage, or
       fistulization. CONCLUSION: An increased awareness of intestinal TB
       coupled with familiarity of the pathophysiology, diagnostic methods, and
       treatment should increase the number of cases correctly diagnosed
       preoperatively and, therefore, improve the outcome of patients with this
       disease.
 DE    Aged  Antitubercular Agents/THERAPEUTIC USE  Biopsy  Case Report
       Colonoscopy  Crohn Disease/DIAGNOSIS  Diagnosis, Differential  Female
       Human  Laparotomy  Sigmoid Diseases/DRUG
       THERAPY/*MICROBIOLOGY/PATHOLOGY/SURGERY  Tuberculosis,
       Gastrointestinal/*DIAGNOSIS/DRUG THERAPY/PATHOLOGY/  SURGERY  United
       States  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

