TROPICAL DISEASE 19

6.3 GASTROINTESTINAL TUBERCULOSIS

Gastrointestinal tuberculosis constitute nearly 1 percent of  all hospital   admission  

and  11  percent   of   small   intestinal obstruction.

These figures are low if compared with the clinical experience of

Surgeons.

The   explanation   is  that  establishing   the   diagnosis   of

tuberculosis  by  histopathology or demonstration of  bacilli  is

difficult.

6.3.1 PATHOLOGY

The abdominal cavity may be affected with tuberculosis through;   

   *  Primary  infection  due to direct ingestion  of  tubercular

      bacillus

   *  Spread from tuberculosis from other parts of the body

   *  Spread from female genital tract

There are three types of lesions seen:

   *  Ulcerative

   *  Fibrotic

   *  Hyperplastic

On  histology  a  typical granuloma  is  seen  however  caseation

necrosis is not always present.

Identification of tubercle bacilli is rare.

A  granuloma may show central caseation surronded  by  epitheloid

and  Langhans giant cells there are also areas  with  lymphocytes

and plasma cells.

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