内視鏡検査で診断した腸結核の3例 Three cases of intestinal tuberculosis diagnosed by endoscopy

We report our three cases of intestinal tuberculosis in which none showed respiratory symptoms. Case 1 : A male of 60's. Lower abdominal pain was persistent for a month and fecal occult blood tests were positive. Type 2 colonic cancer of the cecum was doubted by colonoscopy (CS) in the local doctor and he was introduced to our hospital. CS revealed ulceration and stenosis at the ileocecal area. Biopsy of the ulceration showed granulomatous lesion and lead to diagnosis of tuberculosis. Chest X-ray showed lung lesions as well. Case 2 : A male of 50's. Because persistent diarrhea for three weeks later evolves to right lower abdominal pain and vomiting, he was admitted. CS showed ulceration of the terminal ileum and ileocecal valve. Biopsy of the ulceration showed granulomatous lesion and lead to diagnosis. Sputum was positive for tubercle bacilli and lead to diagnosis of lung and intestinal tuberculosis. Case 3 : A female of 30's. Abdominal pain and diarrhea repeated for a year and CS was performed. The intestine from terminal ileum to sigmoid colon showed skipping lesions of circular ulcers. Ileocecal biopsy showed Tb-PCR positive and lung lesion were suspected on chest X-ray. There were all of three cases ulcerative lesions on the ileocecal area, and tubercle bacilli were able to be detected.