Endoscopy 2006; 38(6): 592-597
DOI: 10.1055/s-2006-924996
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Analysis of Colonoscopic Findings in the Differential Diagnosis Between Intestinal Tuberculosis and Crohn’s Disease

Y.  J.  Lee1 , S.-K.  Yang1 , J.-S.  Byeon1 , S.-J.  Myung1 , H.-S.  Chang1 , S.-S.  Hong1 , K.-J.  Kim1 , G.  H.  Lee1 , H.-Y.  Jung1 , W.-S.  Hong1 , J.-H.  Kim1 , Y.  I.  Min1 , S.  J.  Chang2 , C.  S.  Yu3
  • 1 Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • 2 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • 3 Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Further Information

Publication History

Submitted 9 June 2005

Accepted after revision 15 September 2005

Publication Date:
27 April 2006 (online)

Background and Study Aims: Intestinal tuberculosis and Crohn’s disease are chronic inflammatory bowel disorders that are difficult to differentiate from one another. This study aimed to evaluate the diagnostic value of various colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn’s disease.
Patients and Methods: Colonoscopic findings on initial work-up were prospectively recorded in patients with an initial diagnosis of either intestinal tuberculosis or Crohn’s disease. These findings were analyzed after a final diagnosis of intestinal tuberculosis (n = 44) or Crohn’s disease (n = 44) had been made after follow-up.
Results: Four parameters (anorectal lesions, longitudinal ulcers, aphthous ulcers, and cobblestone appearance) were significantly more common in patients with Crohn’s disease than in patients with intestinal tuberculosis. Four other parameters (involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps) were observed more frequently in patients with intestinal tuberculosis than in patients with Crohn’s disease. We hypothesized that a diagnosis of Crohn’s disease could be made when the number of parameters characteristic of Crohn’s disease was higher than the number of parameters characteristic of intestinal tuberculosis, and vice versa. Making these assumptions, we calculated that the diagnosis of either intestinal tuberculosis or Crohn’s disease would have been made made correctly in 77 of our 88 patients (87.5 %), incorrectly in seven patients (8.0 %), and would not have been made in four patients (4.5 %).
Conclusions: A systematic analysis of colonoscopic findings is very useful in the differential diagnosis between intestinal tuberculosis and Crohn’s disease.

References

S.-K. Yang, M.D.

Division of Gastroenterology, Department of Internal Medicine

Asan Medical Center · 388-1 Pungnap-dong · Songpa-gu · Seoul 138-736 · Korea

Fax: +82-2-485-5782

Email: sky@amc.seoul.kr