Atypical serious hematochezia and rare imaging feature in gastrointestinal tuberculosis

Clinical Journal of Gastroenterology
Jing LiuHuahong Wang

Abstract

A young patient had serious hematochezia for nearly 2 months without obvious cause. Abdominal CT images showed rare features such as serious hemorrhage and multiple miliary nodules in the small bowel. The colonoscopy showed multiple lymphoid follicles in the terminal ileum. The laparotomy showed adverse adhesion in the abdominal cavity and multiple miliary noduli in the surfaces of small bowel wall. The pathology suggested tuberculosis. This patient received anti-TB therapy and the condition improved gradually. There are many variants of GI tuberculosis demonstrating uncommon and rare imaging features. It turned to be difficult in diagnosis when it showed the rare appearance, such as the great amount of intestinal bleeding and multiple noduli in our case. The reason why gastrointestinal bleeding might be attributed to the invasiveness of submucosal vessels by the tuberculosis bacteria. And the multiple noduli on the bowel wall might be the granuloma formation. Therefore, from the experience of our case, gastrointestinal tract might also be the first and only involved site, and it may cause great amount of bleeding to a life danger, even in young people.

References

May 24, 2005·European Journal of Radiology·José M PereiraIsabel Ramos
Jan 29, 2011·World Journal of Gastroenterology : WJG·Anna Benjamin PulimoodBalakrishna Siddhartha Ramakrishna
Jan 4, 2012·Clinical Radiology·W-K LeeS D Chang
Feb 9, 2016·Journal of Digestive Diseases·Jia Yi MaZhi Hua Ran

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Citations

Nov 5, 2020·Revista Do Instituto De Medicina Tropical De São Paulo·Ana Carolina Etrusco Zaroni SantosAnna Carlota Mott Barrientos

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