Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 248-256
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.248
Intestinal tuberculosis with small bowel stricture and hemorrhage as the predominant manifestation: Three case reports
Gang Huang, Kang-Kang Wu, Xiao-Na Li, Jing-Hua Kuai, Ai-Jun Zhang
Gang Huang, Kang-Kang Wu, Xiao-Na Li, Jing-Hua Kuai, Ai-Jun Zhang, Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao 266000, Shandong Province, China
Co-first authors: Gang Huang and Kang-Kang Wu.
Author contributions: Huang G and Wu KK contributed to manuscript writing and editing; LI XN contributed to data collection; Kuai JH contributed to conceptualization; Zhang AJ contributed to proofreading and supervision; Huang G and Wu KK contributed equally to this work as co-first authors; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Hua Kuai, MD, Doctor, Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, No. 758 Hefei Road, Shibei District, Qingdao 266000, Shandong Province, China. kuaijinghua123@126.com
Received: November 20, 2023
Peer-review started: November 20, 2023
First decision: December 11, 2023
Revised: December 24, 2023
Accepted: January 4, 2024
Article in press: January 4, 2024
Published online: January 27, 2024
Abstract
BACKGROUND

Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum. Small bowel tuberculosis, characterized by predominant involvement of the small intestine, is an extremely rare condition with highly atypical clinical presentations, making diagnosis even more challenging.

CASE SUMMARY

We report three cases of small intestinal tuberculosis, two of the patients presented primarily with abdominal pain, and one presented with gastrointestinal bleeding. All patients underwent blood tests and imaging examinations. Small bowel endoscopy (SBE) revealed that the main lesions in these patients were intestinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers. One patient ultimately underwent surgical treatment. Following a complex diagnostic process and comprehensive analysis, all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment, leading to an improvement in their condition.

CONCLUSION

Patients with SBTs present with nonspecific symptoms such as abdominal pain, weight loss, and occasional gastrointestinal bleeding. Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagnosis and complications.

Keywords: Intestinal tuberculosis, Gastrointestinal hemorrhage, Small bowel endoscopy, Case report

Core Tip: Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis and primarily affects the ileum and cecum. Small bowel tuberculosis (SBT) is rare. We report three cases in which patients with SBTs presented with intestinal stenosis or bleeding. Following a complex diagnostic process involving procedures such as small bowel endoscopy and even surgical intervention, all patients were definitively diagnosed and received standard antituberculosis treatment. SBT manifests primarily with nonspecific symptoms such as abdominal pain, weight loss, and occasional gastrointestinal bleeding. A comprehensive evaluation of clinical symptoms and various examinations including laboratory tests, endoscopy, and pathology, are essential for obtaining an accurate diagnosis.