Rana Surinder Singh, Sharma Vishal, Sharma Ravi, Nada Ritambhra, Gupta Rajesh, Bhasin Deepak Kumar
1 Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
2 Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Trop Doct. 2017 Apr;47(2):113-118. doi: 10.1177/0049475516686542. Epub 2017 Jan 6.
Differentiation of small bowel tuberculosis (SBTB) from Crohn's disease (CD) is a diagnostic challenge. We studied 52 patients with suspected SBTB or CD with terminal ileal involvement, who were prospectively enrolled. After confirming patency of the gastrointestinal tract, 26 patients underwent capsule endoscopy (CE). A final diagnosis of CD was found in 18 patients and SBTB in eight patients. All SBTB patients had involvment of the ileocecal valve (ICV) with large (n = 6) and aphthous (n = 2) ulcers in the ileal segment. In CD, ICV involvement was seen in five (33%) patients. Large and aphthous ulcers were observed in seven (47%) and 15 (100%) patients, respectively. On comparison with CD, patients with SBTB had increased frequency of ICV involvement ( P = 0.002) and lesser frequency of aphthous ulcers ( P = 0.007). CE can help in differentiating CD from SBTB by the position of its involvement and the type of ulcers present.
鉴别小肠结核（SBTB）与克罗恩病（CD）是一项诊断挑战。我们对52例疑似SBTB或累及回肠末端的CD患者进行了前瞻性研究。在确认胃肠道通畅后，26例患者接受了胶囊内镜检查（CE）。最终诊断为CD的患者有18例，SBTB患者有8例。所有SBTB患者的回盲瓣（ICV）均受累，回肠段有大溃疡（n = 6）和阿弗他溃疡（n = 2）。在CD患者中，5例（33%）出现ICV受累。分别有7例（47%）和15例（100%）患者观察到有大溃疡和阿弗他溃疡。与CD相比，SBTB患者ICV受累的频率更高（P = 0.002），阿弗他溃疡的频率更低（P = 0.007）。CE可通过受累部位及溃疡类型帮助鉴别CD与SBTB。
