Intestinal tuberculosis

Indications Spleen/kidney vacuity cold. Chronic colitis, chronic dysentery, autonomic dystonia of the intestinal tract, intestinal tuberculosis, allergic colitis, tabes dorsalis, and pancreatic dysfunction... 

Fig. 5.28. Intestinal tuberculosis. CT scan shows the heterogenic, hypodense masses with peripheral ringlike calcifications following lymphadenitis and ascites...

Figure 22 represents a moderately high Brdi6ka filtrate reaction, which at first increases a little and then keeps level the patient had suspected intestinal tuberculosis and malabsorption syndrome. 

Figure 22. Brdi6ka filtrate reaction, course of denaturation in time at 20°C at 7-min intervals. Relatively high wave initially increased by denaturation, but with no further change suspected intestinal tuberculosis and malabsorption syndrome.

Sonography may be used in patients with intestinal tuberculosis to document its classic features, i.e., bowel wall thickening, hyperemia, stricture, and mesenteric lymphadenopathy. When tuberculous peritonitis coexists, sonography shows ascites, omental cake, and thickened mesentery with an adherent small bowel loop thus, ultrasonography maybe used as a primary investigative tool in patients with suspected or recurrent tuberculosis. 

Intestinal tuberculosis is a chronic inflammation of the bowel caused by Mycobacterium tuberculosis. The ileocecal area is the most common site. The classic radiographic appearance of ileocecal tuberculosis on barium enema has been described as a conical, shrunken, retracted cecum associated with a narrow ulcerated terminal ileum (Reeder and Palmer 1989). This cecal deformity is the result of spasm early in the disease and transmural infiltration with fibrosis in advanced phases. Narrowing of the terminal ileum may be caused by persistent irritability with rapid emptying of the narrowed segment, corresponding to the acute inflammatory phase, or it may be the result of stricture with thickening and ulceration. 

Ultrasonography detects ulceration within the thickened wall in only a few cases, whereas it is seen frequently during small bowel follow through examination or barium enema studies. This low sensitivity for the detection of ulcers on sonography may be due to the associated spasm (Kedar 1994). Lymphoid tissue involvement in the ileal wall with ulceration, necrosis, fibrosis, and often with extensive granulomatous infiltrate can be observed (Khaw 1991). In a few cases of intestinal tuberculosis, a spasm of the cecum is identified by a collapsed lumen and irritability of the thickened wall (Lee et al. 1993). 

In the active stage of intestinal tuberculosis,bowel wall thickening is usually accompanied by luminal narrowing, which results from spasm and edema. Later, fibrosis and scarringlead to permanent stricture (Fig. 12.5) however, it is difficult to detect stricture during sonographic examinations (Kedar et al 1994). 

Crohn s disease (Ulcerative) colitis Intestinal ischaemia Intestinal tuberculosis Intestinal invagination Diverticulitis Post-radiation enteritis Adenocarcinoma Gastrointestinal stromal tumour Intestinal metastases Appendicitis Intramural haematoma... 

While Azerbaijan has been hardest hit by pollution from oil exploitation, other littoral and neighboring states also have been adversely affected. In Kazakhstan, environmental tests have noted that cases of blood disease, tuberculosis, and other diseases as well as the relevant enviroenmental risks are four times more common in the Caspian area than the rest of the country s average. Although the tests showed that the environmental contamination in the northeast Caspian is less than what has been recorded previously, water which has been contaminated by oil-products in Kazakhstan is still used for drinking water. This contamination is cited as a main reason for intestinal infections in Kazakhstan s coastal areas. 

Interestingly, infections by commonly occurring bacteria (such as those in the lower intestine) do not generally occur in adult AIDS patients, perhaps because components of the immune system responsible for controlling the common bacteria are less affected by HIV infection. However, children bom infected with AIDS often do develop lung infections with common bacteria. In addition, adult AIDS patients may experience infections with tuberculosis-like bacteria. 

Gastrointestinal colic (as antispas-modic) Belladonna alkaloids relax the spasm of smooth muscles of intestinal, urinary and biliary tract. They are also effective in functional and drug induced diarrhoea, to relieve urinary urgency and frequency and enuresis in children. They are also used to reduce gastric secretion in peptic ulcer patients. Also, used to reduce the excessive sweating in tuberculosis and sweating and salivation in parkinsonian patients. 

One girl in her third year, who had been immunized against tuberculosis at birth, developed an abscess of the associated lymph nodes (which were extirpated) and some weeks later developed intestinal BCG dissemination, which appeared to be cured by tuberculostatic treatment. Despite this, at the age of 22 years she developed a leftsided hemiplegia due to aneurysms and thrombosis of cerebral arteries, and 4 years later an oculomotor nerve paralysis was diagnosed. She died at 26 from recurrent intestinal BCG dissemination, which developed at the end of a pregnancy (a healthy premature child was bom). 

Severe parkinsonism has been reported in a 73-year-old woman with tuberculosis of the large intestine who had taken metoclopramide for nausea she recovered on withdrawal of the drug and treatment with biperiden (7). 

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