Gastrointestinal tuberculosis

Case contributed by Dr Nathan David P. Concepcion


Chronic diarrhea.

Patient Data

Age: 15 years
Gender: Female

Radiograph of the right lower quadrant as part of the small intestinal series shows narrowing of the terminal ileum ("string sign") due to small bowel wall thickening, with a dilated more proximal ileal segment.

Case Discussion

The ileocecal region, primarily terminal ileum, is the most common area of involvement in gastrointestinal tuberculosis (TB). The terminal ileum, ileocecal junction and the cecum are concurrently involved in the majority of cases. The most common complication is obstruction due to luminal narrowing ("string sign") caused by the hyperplastic mural thickening, ileal strictures and/or by adhesions. Malabsorption is also a common complication and may present with chronic diarrhea.

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