Differential Diagnosis for Intestinal Tuberculosis in Elder Patient – Case Report

Introduction  Intestinal tuberculosis (ITB) presents with clinical features that often mimic malignant or inflammatory diseases. Diagnosis is established through a combination of endoscopic, radiological, and pathological findings.

Case  A 76-year-old woman presented with acute, diffuse abdominal pain. Computed tomography (CT) of the abdomen revealed subocclusion due to wall thickening at the ileocecal transition. A colonoscopy biopsy showed ulcerated granulomatous lesions, with negative results for AFB. Enterography suggested the possibility of a neoplastic disease. Due to the subocclusion, the patient underwent a segmental right ileocolectomy and ileocolostomy with a double-barrel stoma. Histopathological analysis of the resected specimen, including frozen section examination, confirmed ITB.

Conclusion  The diagnosis of ITB is challenging due to its clinical, endoscopic, radiologic, and histopathologic features, which overlap with neoplasms and inflammatory bowel disease. Therefore, establishing an appropriate therapeutic approach requires the integration of multiple diagnostic findings.

Keywords
intestinal tuberculosis; inflammatory bowel disease; colectomy