Colonoscopic features of patients with active pulmonary tuberculosis *
To elucidate the colonoscopic features of patients with active pulmonary tuberculosis, we performed colonoscopy on eight consecutive patients with pulmonary tuberculosis, for whom a diagnosis of active pulmonary tuberculosis was made based on radiologic and bacteriologic examinations. These patients, who were all male, ranged in age from 36 to 73 years old with a mean age of 58 years old. Three patients had no symptoms, five presented with a mild cough and low-grade fever alone. No abnormal findings were revealed in six patients by colonoscopic examination. However, in the remaining two patients, subtle lesions were found in the ileocecal region;a tiny aphthoid erosion of the cecum in one patients and a small ulcer of the terminal ileum in one. These lesions were cured completely following anti-tuberculous treatment alone. Although the culturing of biopsy specimens did not lead to isolation of Mycobacterium tuberculosis and no caseating epithelioid cell granulomas were present in any of the two patients, a clinical diagnosis of intestinal tuberculosis was made based on their clinicotherapeutical course. With the increasing availability of colonoscopy, we are likely to encounter patients with tuberculosis in whom a diagnosis of pulmonary or extra-pulmonary tuberculosis may not have been made yet. When ulcerating lesions are found in the ileocecal region, tuberculosis should be considered even if the intestinal lesions are subtle and atypical for tuberculosis. (Accepted on December ８，2005)
