[Ileocecal tuberculosis. Apropos of 27 cases].

Abstract

The authors report a retrospective study of 27 cases of "ileo-caecal tuberculosis" collected over a period of 10-years. Sixteen women and eleven men, between 14 and 55 years of age (with a group mean age of 28 years), were included. This is still a common disease in Morocco, despite attempts to achieve universal BCG vaccination. Diarrhoea, abdominal pain and a general physical deterioration are the most indicative signs, but are not specific. Tests for M. tuberculosis hominis are often negative, except in cases in which bacteria proliferate in pulmonary excavations, and this makes it difficult to establish a definite diagnosis. The detection of narrowing of the ileum or colon in a country where infection is endemic suggests the possibility of tuberculosis. Colonoscopy, which is becoming increasingly widespread in Morocco, makes an essential contribution. Although it is rare for caseum to be detected in biopsy fragments, the main value of histopathology is that it can eliminate cancer, making it possible to start antibacterial treatment without a diagnostic laparotomy. The outcome of medical treatment is nearly always positive. Clinical improvement, bacteriology tests and X-ray examinations are criteria that a cure has been obtained.