Intestinal tuberculosis with abdominal complications: radiologic and pathologic features

Background: To investigate radiologic and pathological features of intestin al tuberculosis with abdominal complications. Methods: Twenty-two patients with 23 surgically proven complications (nine intestinal obstructions, eight perforations, three fistulae, and three inte stinal bleeds) were analyzed. Medical records, radiologic studies, and path ologic examinations were reviewed with special emphasis on searching for th e common features in each group of complication. Results: The most important single feature in seven of the nine patients wi th intestinal obstruction was the presence of stricture. In the remaining t wo patients, bowel adhesion was a primary cause of obstruction. In eight pa tients with intestinal perforation, both obstruction and ulcerations in the dilated proximal loop were the important features in six, and multiple dee p ulcerations without obstruction was a primary cause in the remaining two. The common features in three patients with fistulae were focal or multiple strictures, severe adhesions, and fibrotic bowel wall. Intestinal bleeding originated from diffuse mucosal ulcerations. The abdominal complications o ccurred during antituberculous therapy in 10 of the 22 patients. Conclusion: Understanding the radiologic and pathologic features of intesti nal tuberculosis with complications help in making an appropriate clinical decision for the treatment strategy. Close observation is necessary, especi ally in those patients who are acutely ill during antituberculous medical t herapy.