Intestinal TB v/s Crohn’s disease –Mystery solved?

Abstract
In countries like India where TB is endemic, it is extremely difficult to differentiate between Intestinal-TB and Crohn’s-disease as both have overlapping clinical, radiological, endoscopic and histological features [1-4]. Incorrect diagnosis causes increased morbidity and mortality. Hence, there is a need for an imaging test that can accurately diagnose both and can be easily integrated into existing clinical practice. We describe a new technique of CT perfusion for differentiation between the two diseases. We present 2 cases (biopsy proven) of intestinal-TB and Crohn’s-disease. The clinical, laboratory investigations, imaging and endoscopic findings will be discussed along with analysis of the perfusion parameters. The final diagnosis will be considered according to the biopsy findings. We conclude that CT perfusion is a highly sensitive and specific non invasive imaging modality for differentiation between intestinal-TB and crohn’s-disease.