title: [A case of intestinal tuberculosis with perianal fistula diagnosed after 30 years].
abstract: Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kosin University Gospel Hospital, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Cheon
authors.forename: Won
authors.initials: W
authors.lastname: Moon
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Youn Jung
authors.initials: YJ
authors.lastname: Choi
authors.forename: Jong Bin
authors.initials: JB
authors.lastname: Kim
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Kwon
mesh_terms: D001003:Anal Canal; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D005402:Fistula / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007080:Ileocecal Valve / Q000503:physiopathology; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D011486:Protein C / Q000032:analysis; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000995:Antitubercular Agents; D011486:Protein C; D019804:Mesalamine