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Hépato-Gastro & Oncologie Digestive

Gastrointestinal tuberculosis Volume 19, numéro 1, Janvier 2012

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The abdomen is one of the common sites of extrapulmonary involvement of tuberculosis. Abdominal tuberculosis refers to peritoneum, gastro-intestinal tract, abdominal lymphatic system, and solid visceral organs. Abdominal tuberculosis is characterized by the diversity of its clinical and radiological aspect. The diagnosis is often difficult and is based on imaging and endoscopy. The barium opacification and endoscopy allow the study of digestive tract ; CT and ultrasound allow the study of visceral involvement, guiding biopsy and aspiration of abscess collections. The most frequently site of gastro-intestinal tuberculosis is ileo-caecal region. The main differential diagnosis of intestinal tuberculosis is Crohn's disease. It is difficult but essential to differentiate intestinal tuberculosis and Crohn disease, for the immune suppression necessary to treat the latter can induce severe complications of the former. Management of intestinal tuberculosis is primarily medical, with surgery reserved for complications.