Colonic tuberculosis or Crohn's disease ? An important differential diagnosis

Abdominal tuberculosis can mimic any disease affecting the gastrointestinal tract such as infectious processes, tumors, peri- appendiceal abscess, and Crohn's disease. The differential diagno- sis of Crohn's disease and intestinal tuberculosis is a dilemma to clinicians and pathologists as both are chronic granulomatous dis- orders with similar clinical features. Lower gastrointestinal bleed- ing is an infrequent presentation of both intestinal tuberculosis and Crohn's disease. Herein, we report a 56-year-old woman present- ing with massive hematochezia due to isolated colon tuberculosis in whom the initial diagnostic work-up suggested Crohn's disease and review the current literature. Our report highlights the need for awareness of colonic tuberculosis in the differential diagnosis of massive hematochezia from Crohn's disease, especially before ini- tiating treatment with immunosuppressive agents. (Acta gastro- enterol. belg., 2013, 76, 59-61).