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Since colonic tuberculosis is uncommon and its bifocal pseudo-tumor form is exceptional, differential diagnosis with the colonic cancer is exceedingly difficult. The purpose of this report is to describe a case of primary colonic tuberculosis in two separate locations discovered in a patient presenting with persistent massive hematochezia. A 69-year-old woman was examined for hematochezia, abdominal pain and recent weight loss. Colonoscopy revealed the presence of two ulcerated tumor-like lesions in right colon. One of these lesions caused significant stenosis. Histological examination of biopsy specimens was inconclusive. Colonic tumor with bleeding was considered as the most likely diagnosis. Surgical exploration demonstrated one tumor in the cecum and another in the ascending colon. Right hemicolectomy was performed. Histological examination of the surgical specimen demonstrated a granulomatous reaction pattern with caseous necrosis. Conventional antituberculosis treatment led to clinical improvement.

Gastrointestinal tuberculosis represents 1% of extrapulmonary tuberculoses and only sporadic cases of anal tuberculosis have been reported in the literature. We report two cases of tuberculous anal abscess and a review of the literature for diagnosis and treatment.

We report two cases of pancreatic tuberculosis. The first patient had abdominal pain, jaundice and weight loss. Ultrasonography and CT scan suggested a pancreatic tumor. The second patient presented with abdominal pain without jaundice while CT scan showed a pancreatic mass. Diagnosis of pancreatic tuberculosis was made at laparotomy in the two cases. The two patients underwent hepatico-jejunostomy. The first one received antituberculous chemotherapy and completely recovered while the second died because of post-operative shock related to sepsis. Tuberculosis must be suspected in the presence of a pancreatic mass in endemic countries or in immunocompromised patients. Needle biopsy may in some cases lead to diagnosis and avoid laparotomy.

The authors report a case of ileocaecal tuberculosis in a 27-year-old man with no particular risk factor for this disease. The initial diagnosis was terminal ileitis discovered at appendicectomy. The diagnosis of ileal tuberculosis was suspected in the presence of giant cell follicles on ileal biopsies, and was confirmed by the presence of AFB in the gastric intubation fluid. This patient presented known atypical pulmonary images for several years, which had never been investigated in more detail. A favourable course was observed in response to triple-agent, then double-agent antibiotic therapy. This case illustrates the fact that ileal tuberculosis still exists today, and that it does not exclusively affect "high-risk" patients.

The authors report a retrospective study of 6 cases suffering from gastroduodenal tuberculosis which occurred in our gastroenterology department during a period of 14 years. This affection is rare and set a lot of diagnosis problems with a gastroduodenal neoplastic affection because of its clinical polymorphism and its radio endoscopic aspects which are very confusing. The association with a localisation of another tuberculosis has been found in all cases and this allowed us to guide the diagnosis. The specific medical treatment by antibacillaires rely on histologic evidence, either by epidemiologic arguments, clinic, paraclinic and therapeutic evidence.

The perforation into free peritoneum is a singular complication of the intestinal tuberculosis. Regarding a recent observation of this complication revealing small intestinal tuberculosis, we have tried to make the point on this exceptional form of small intestinal tuberculosis. By means of prolonged enteric nutrition and antitubercular treatment, the patient will be cured of this disease without any after-effects as we mentioned it in our observation. Very fearsome in the past (44 deaths out of 104 published cases), perforation into free peritoneum nowadays has a better prognosis.