| Objective To analyze the clinical data of intestinal tuberculosis which was confirmed by pathology,to improve the ability of diagnosis of intestinal tuberculosis.
Methods 18 cases of intestinal tuberculosis which was confirmed by pathology admitted to the department of gastroenterology of the first affiliated hospital of anhui medical university from January 2017 to June 2018 were analyzed retrospectively.The laboratory, imaging, endoscopic and pathological features were analyzed，to summarize the characteristics of intestinal tuberculosis and diagnostic experience.
Results Among the 18 patients, 16 (88.9%) had abdominal pain and 11 (61.1%) had diarrhea.The positive rate of t-spot.tb and PPD was 83.3% (15/18) and 55.6% (10/18) respectively.Imaging examination showed that 10 cases (55.6%) were complicated with pulmonary tuberculosis. The diagnostic rate of pulmonary tuberculosis was 22.2% (4/18) by chest X-ray, and 42.9% (6/14) by chest high-resolution CT.Analysis of features of small intestine CT (CTE) showed focal involvement in ileocecal area in 12 cases (66.7%), symmetrical thickening of intestinal wall in 11 cases (61.1%), annular enhancement of lymph nodes in 10 cases (55.6%), and ascites in 7 cases (38.9%).Enteroscopy showed annular ulcer in 10 cases (55.6%), rat bite in 8 cases (44.4%), ileocecal contracture in 4 cases (22.2%).All the 18 patients were confirmed by pathology. The positive rate of acid-fast staining by histopathology was 83.3% (15/18), and the detection rate of caseous necrotizing granuloma was 44.4% (8/18).
Conclusion Due to the lack of specificity in clinical features of intestinal tuberculosis, emphasis should be put on strengthening histopathology, combining with laboratory and imaging examinations, to improve the level of diagnosis of intestinal tuberculosis. |
