[GASTROINTESTINAL TUBERCULOSIS]
Tuberculosis is an ancient disease, still with highprevalence in developing countries. In Western countries there is anincreased incidence, perhaps by immigrants of the Third World, by peoplewith low socioeconomic status, and AIDS. Gastrointestinal tuberculosis, aspulmonary tuberculosis, is a common and serious problem. Symptoms and signsare nonspecific; general syndrome, fever with digestive syndrome, andabdominal pain is frequent. Digestive syndrome presents diarrhea, nausea andvomiting, abdominal pain and tenderness, abdominal mass, hepatomegaly, andassociated ascites. More than 80 percent of cases in our series have activepulmonary tuberculosis. Radiology with Barium in small bowel and colon areimportant diagnostic methods, but colonoscopy with biopsy and stained slides for acid-fast bacilli and caseose granuloma are of high yield in the colon, ileon, or ileocecal localization. If any doubt exists, therapeutic trial and exploratory laparotomy can be used. Important advances have been made in gastrointestinal tuberculosis serodiagnosis. Treatment is the same as for pulmonary tuberculosis, with short regimens; although, in certain cases, this regimen may last from 18 to 24 months. Surgical treatment is required for tuberculosls complications.
Celestino A
Alvaro
DR