Difficulties in the diagnosis and management of unsuspected tuberculous enteritis and colitis

Abstract

Five patients with tuberculous enteritis and one with possible tuberculous colitis are described, all of whom presented difficult problems of diagnosis and management. Chest radiographs were normal in three cases, and radiology of the bowel was misleading in five. Two developed intestinal malabsorption with megaloblastic anaemia. The finding of tubercle bacilli in the faeces presented an important diagnostic problem in one of the cases with a normal chest radiograph. All the patients required both medical and surgical treatment, and the outcome in five has been very good and relatively satisfactory in the sixth. The last case particularly illustrates the difficulty of ultimate diagnosis in some patients with granulomatous or ulcerative entero-colitis.