Endoscopy 2004; 36(7): 612-616
DOI: 10.1055/s-2004-814518
Original Article
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Biopsies from Normal-Appearing Terminal Ileum and Cecum in Patients with Suspected Colonic Tuberculosis

S.  P.  Misra1 , M.  Dwivedi1 , V.  Misra1 , M.  Gupta1 , B.  K.  Kunwar1
  • 1Dept. of Gastroenterology and Dept. of Pathology, Motilal Nehru Medical College, Allahabad, India
Further Information

Publication History

Submitted 18 February 2004

Accepted after Revision 2 March 2004

Publication Date:
09 July 2004 (online)

Background and Study Aims: Colonic tuberculosis is generally diagnosed by colonoscopy and targeted biopsy of lesions. However, the diagnostic yield of colonic biopsies is not very good. So far as we are aware, there have been no studies investigating the role of biopsies from endoscopically normal-appearing cecum and terminal ileum in diagnosing colonic or ileal tuberculosis, or both.
Patients and Methods: Patients with a clinical suspicion of colonic tuberculosis, in whom no endoscopic abnormalities were found on colonoscopy or ileoscopy, were included in the study. Multiple biopsies were obtained from the cecum and ileum.
Results: Fifty patients were studied. Intubation of the terminal ileum was possible in 43 patients (86 %). Histological examination of biopsies obtained from the cecum and terminal ileum showed noncaseating granuloma in two patients. Both of these biopsies were from the terminal ileum. In two other patients, collections of loosely arranged epithelioid cells were observed. This established the diagnosis in these four patients (8 %). In the remaining 46 patients, histology showed nonspecific inflammation in 18 patients (in the cecum in 15 and in the terminal ileum in seven). The other biopsies did not show any abnormalities (33 from the cecum, 34 from the terminal ileum).
Conclusions: Histological examination of biopsies from the normal-appearing cecum and terminal ileum is useful in a small but significant number of patients with colonic tuberculosis.

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S. P. Misra,M. D. 

Dept. of Gastroenterology · Motilal Nehru Medical College

Allahabad 211001 · India ·

Fax: +91-532-2611420

Email: misrasp@rediffmail.com; spmisra@sancharnet.in