Medical expert of the article
New publications
Intestinal tuberculosis: causes and pathogenesis
Last reviewed: 19.10.2021
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Tuberculosis of the intestine can be an expression of the primary (primary intestinal tuberculosis complex), secondary (intrakanalkulyarnoe infection with cavernous pulmonary tuberculosis) or hematogenous extrapulmonary tuberculosis. Dominant manifestations of primary tuberculosis (often chronically current), accounting for 70% of cases of abdominal forms of tuberculosis. The path of spreading is lymphogenic ("adenogenic").
In primary tuberculosis, intestinal damage is often associated with bovine mycobacterium (Mycobacterium bovis), with secondary and hematogenous tuberculosis with mycobacteria of the human (Mycobacterium tuberculosis) or intermediate (Mycobacterium africanum) species.
Tuberculosis of the intestine until recently was not a rarity. Thus, secondary tuberculosis of the intestine, concomitant with the terminal stage of pulmonary tuberculosis, has been known since the time of Hippocrates. The appearance of bloody diarrhea in patients with pulmonary tuberculosis was considered a harbinger of an unfavorable outcome of the disease. It can be assumed that intestinal tuberculosis occurs much more often than it is diagnosed, existing under such "masks" as peptic ulcer, Crohn's disease, chronic enteritis, etc. Often it is an accidental finding during an operation or autopsy.
Morphological manifestations of lesions are found mainly in the ileocecal part of the intestine. The terminal department of the ileum and the cecum are involved in the process - tuberculous ileotiflilit. The appendix, ascending, transverse colon and other parts of the intestine are less often affected. Tuberculosis of the rectum may be a manifestation of diffuse tuberculous colitis; the occurrence of secondary lesions of the intestine with the outcome in the pararectal abscesses and fistulas is possible. Rarely, a specific infectious process passes to the rectum from the tuberculosis-affected appendages of the uterus or prostate.
Depending on the stage and severity of the tuberculous process in the intestine, its various forms can be found: along with specific granulomatosis, ulceration and stenosis are frequent due to the growth of connective tissue. Therefore, among the complications of tuberculosis are found as perforations with the development of tuberculous peritonitis (bleeding is rare), and adhesions, strictures leading to intestinal obstruction.