title: [Severe rectal bleeding in an Tunisian woman: colonic tuberculosis mimicking a tumor].
abstract: Since colonic tuberculosis is uncommon and its bifocal pseudo-tumor form is exceptional, differential diagnosis with the colonic cancer is exceedingly difficult. The purpose of this report is to describe a case of primary colonic tuberculosis in two separate locations discovered in a patient presenting with persistent massive hematochezia. A 69-year-old woman was examined for hematochezia, abdominal pain and recent weight loss. Colonoscopy revealed the presence of two ulcerated tumor-like lesions in right colon. One of these lesions caused significant stenosis. Histological examination of biopsy specimens was inconclusive. Colonic tumor with bleeding was considered as the most likely diagnosis. Surgical exploration demonstrated one tumor in the cecum and another in the ascending colon. Right hemicolectomy was performed. Histological examination of the surgical specimen demonstrated a granulomatous reaction pattern with caseous necrosis. Conventional antituberculosis treatment led to clinical improvement.
authors.affiliation: Service de chirurgie générale, EPS Hèdi Chaker, Sfax, Tunisie. abid_med_chu@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Abid
authors.forename: M
authors.initials: M
authors.lastname: Ben Amar
authors.forename: Y
authors.initials: Y
authors.lastname: Dammak
authors.forename: A
authors.initials: A
authors.lastname: Amouri
authors.forename: H
authors.initials: H
authors.lastname: Cheikhrouhou
authors.forename: M
authors.initials: M
authors.lastname: Khalif
authors.forename: L
authors.initials: L
authors.lastname: Ayadi
authors.forename: R
authors.initials: R
authors.lastname: Mzali
authors.forename: M F
authors.initials: MF
authors.lastname: Frikha
authors.forename: M I
authors.initials: MI
authors.lastname: Beyrouti
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002429:Cecal Diseases / Q000175:diagnosis* / Q000601:surgery; D003108:Colonic Diseases / Q000175:diagnosis* / Q000601:surgery; D003110:Colonic Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D012007:Rectum; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000628:therapy; D014416:Tunisia
chemical_list: D000995:Antitubercular Agents