title: Differential diagnosis of Crohn's disease and intestinal tuberculosis in patients with spontaneous small-bowel perforation.
abstract: OBJECTIVE
  Spontaneous small-bowel perforation caused by Crohn's disease (CD) or intestinal tuberculosis (ITB) is a rare disease entity. We investigated the clinical features and radiologic findings of patients with CD or ITB who presented with a spontaneous small-bowel perforation.
  
  
  METHODS
  Between January 2001 and December 2010, sixty-two patients underwent surgery due to a spontaneous small-bowel perforation, including 21 (33.9%) CD patients and 18 (29.0%) ITB patients. Clinical and radiologic features were compared between CD and ITB patients.
  
  
  RESULTS
  The mean age was significantly lower in CD patients than in ITB patients (p = 0.014). Diarrhea was more common in CD. By contrast, night sweating and a previous history of tuberculosis were more common in ITB. Only 27.8% of patients with ITB had a positive QuantiFERON-TB Gold test. CT findings such as bowel wall thickening of more than 10 mm, omental thickening, and intra-abdominal lymphadenopathy larger than 10 mm were more common among perforations caused by ITB. Mesenteric fat infiltration was a more frequent finding in CD than in ITB.
  
  
  CONCLUSIONS
  Clinical symptoms and radiologic findings may aid in the differential diagnosis between CD and ITB in patients presenting with spontaneous small-bowel perforation.
authors: Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors: Su Hwan
authors: SH
authors: Kim
authors: Ji Won
authors: JW
authors: Kim
authors: Ji Bong
authors: JB
authors: Jeong
authors: Kook Lae
authors: KL
authors: Lee
authors: Byeong Gwan
authors: BG
authors: Kim
authors: Young Ho
authors: YH
authors: Choi
mesh_terms: D000328:Adult; D000367:Age Factors; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013546:Sweating; D014057:Tomography, X-Ray Computed; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D055815:Young Adult