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Introduction <p>Tuberculosis remains a significant global health problem, with extrapulmonary involvement occurring in approximately 15–20% of cases. Intestinal tuberculosis may lead to serious complications such as ileus; however, due to the rarity of this condition, the clinical characteristics and outcomes of ileus developing during anti-tuberculosis therapy (ATT) (isoniazid, rifampicin, ethambutol and pyrazinamide) remain poorly defined.</p> Objectives <p>To describe the clinical characteristics, timing, management, and outcomes of reported cases of ileus developing after initiation of ATT for intestinal tuberculosis through a scoping review of published literature.</p> Methods <p>A scoping review was conducted in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed and Scopus was performed to identify case reports describing intestinal tuberculosis associated with ileus during ATT, covering publications from January 1948 to March 2025. Studies meeting predefined eligibility criteria were screened independently by two reviewers, and relevant clinical data were summarized descriptively. Ileus was categorized as mechanical obstruction (due to stricture, adhesion, inflammatory mass, or wall thickening with a defined transition point) or paralytic ileus (functional impairment without a mechanical obstruction). Additionally, a fatal case from our department was included in the analysis.</p> Results <p>A total of 301 records were identified, of which 11 cases met the inclusion criteria. Among these 11 cases, the mean patient age was 49.5 ± 20.0 years; 6/11 were male. Most reported cases originated from Asia, followed by Europe, while one case was reported from Africa. Symptoms typically developed within the first month after initiation of therapy. Abdominal pain was the most frequently reported symptom, occurring in 7/11 cases, followed by vomiting and fever 4/11 cases each. Intestinal obstruction was predominantly mechanical (9/11), and most patients required surgical intervention. One patient received conservative management, and the case from our institution was diagnosed postmortem. Immunosuppressive conditions were documented in 2/11 patients.</p> Conclusion <p>Clinicians should maintain a high vigilance for intestinal obstruction in patients with tuberculosis who develop new abdominal pain, vomiting and fever during the first month of ATT as timely diagnostic evaluation is critical. Abdominal computed tomography (CT) imaging and surgical consultation may aid clinical management, although evidence remains limited.</p> Clinical trial number <p>Not applicable.</p>

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Ileus associated with intestinal tuberculosis after initiation of anti-tuberculosis therapy: a case report and scoping review of published cases

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Csongor Galko,
  • Zsombor Matics,
  • Edit Hidvegi,
  • Gergely Racz,
  • Veronika Müller

摘要

Introduction

Tuberculosis remains a significant global health problem, with extrapulmonary involvement occurring in approximately 15–20% of cases. Intestinal tuberculosis may lead to serious complications such as ileus; however, due to the rarity of this condition, the clinical characteristics and outcomes of ileus developing during anti-tuberculosis therapy (ATT) (isoniazid, rifampicin, ethambutol and pyrazinamide) remain poorly defined.

Objectives

To describe the clinical characteristics, timing, management, and outcomes of reported cases of ileus developing after initiation of ATT for intestinal tuberculosis through a scoping review of published literature.

Methods

A scoping review was conducted in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed and Scopus was performed to identify case reports describing intestinal tuberculosis associated with ileus during ATT, covering publications from January 1948 to March 2025. Studies meeting predefined eligibility criteria were screened independently by two reviewers, and relevant clinical data were summarized descriptively. Ileus was categorized as mechanical obstruction (due to stricture, adhesion, inflammatory mass, or wall thickening with a defined transition point) or paralytic ileus (functional impairment without a mechanical obstruction). Additionally, a fatal case from our department was included in the analysis.

Results

A total of 301 records were identified, of which 11 cases met the inclusion criteria. Among these 11 cases, the mean patient age was 49.5 ± 20.0 years; 6/11 were male. Most reported cases originated from Asia, followed by Europe, while one case was reported from Africa. Symptoms typically developed within the first month after initiation of therapy. Abdominal pain was the most frequently reported symptom, occurring in 7/11 cases, followed by vomiting and fever 4/11 cases each. Intestinal obstruction was predominantly mechanical (9/11), and most patients required surgical intervention. One patient received conservative management, and the case from our institution was diagnosed postmortem. Immunosuppressive conditions were documented in 2/11 patients.

Conclusion

Clinicians should maintain a high vigilance for intestinal obstruction in patients with tuberculosis who develop new abdominal pain, vomiting and fever during the first month of ATT as timely diagnostic evaluation is critical. Abdominal computed tomography (CT) imaging and surgical consultation may aid clinical management, although evidence remains limited.

Clinical trial number

Not applicable.