EC Gastroenterology and Digestive System

IBackground: GeneXpert MTB/RIF assays for diagnosing tuberculosis have been performed in the body secretions with excellent results. But the diagnosing intestinal tuberculosis is challenging due to the limited yield of diagnostic modalities like CT scan, and colonoscopy with blind ileal biopsies.

Objective: To compare the Gene Xpert Mycobacterium tuberculosis and colonoscopic biopsy findings detecting abdominal tuberculosis in a tertiary care hospital in Bangladesh.

Methodology: This cross-sectional hospital-based observational study was carried out among 73 adult patients in the Gastroenterology department of DMCH through admission or referral from May 2015 to April 2016. Laboratory tests, abdominal colonoscopic imaging results, Gene Xpert, colonoscopy with or without ileostomy, etc. were noted.

Result: 21 (28.1%) patients had no abnormality in the colonoscopic finding test. Abnormal findings showed there were colonic mucosal ulcerations in 34 (46.8%), mucosal macronodular lesions in 14 (18.75%), mucosal nodules in 11 (15.6%), colonic strictures in 11 (15.6%), deformed ileocaecal valve in 9 (12.5%), deformed caecum in 7 (9.4%) and polypoid mucosal lesion in 3 (3.1%) patients. Gene Xpert MTB DNA was detected in 33 (45.2%) patients. Diagnostic yield of Gene Xpert to detect MTB DNA on colonoscopic biopsy specimen was found in 29 out of 69 (42.1%) and Ultrasound-guided biopsy of the L/N in 4 out of 4 (100%) patients.

Conclusion: The result of this study highlighted the alternative approach of Gene Xpert diagnoses Mycobacterium tuberculosis that shows rapid results with good diagnostic accuracy.

 Keywords: Abdominal Tuberculosis; Gene Xpert MTB/RIF Assay; Colonoscopy; Biopsy

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