Sigmoid colonic tuberculosis presenting as a colovesical fistula mimicking colorectal malignancy: a case report - Summary - MDSpire

Sigmoid colonic tuberculosis presenting as a colovesical fistula mimicking colorectal malignancy: a case report

  • By

  • Lingfeng Zhong

  • Kun Xia

  • Yanyun Fan

  • June 8, 2026

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Objective:

To highlight the diagnostic challenges of isolated sigmoid tuberculosis (ITB) presenting as a tumor-like lesion complicated by colovesical fistula, which can lead to misdiagnosis.

Key Findings:
  • Isolated sigmoid colonic tuberculosis is rare and can mimic colorectal malignancy or Crohn's disease, complicating diagnosis.
  • Initial histopathology may not reveal granulomas, which can delay appropriate treatment.
  • Integration of imaging, immunological testing, special staining, and mNGS is crucial for accurate diagnosis and timely intervention.
Interpretation:

This case emphasizes the need to consider ITB in differential diagnoses for sigmoid lesions, particularly when typical histological findings are absent, to avoid misdiagnosis.

Limitations:
  • The case is based on a single patient experience, limiting generalizability.
  • Initial histopathological findings may not represent all cases of ITB, and further studies are needed to validate these findings.
Conclusion:

Timely diagnosis of ITB can prevent misdiagnosis and ensure appropriate treatment.

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