Intestinal tuberculosis with an impending perforation: a case report

Author: 
Deepak Bishnoi, Sanjay Singhal, Prashant Jain, Saroj Chhabra Kapoor, Bharat Bhushan Sharma, Dhaval Desai and Ashna Jaggi

Introduction: Abdomen is involved in 11% of the patients with extra pulmonary tuberculosis. The most common site involved is ileocaecal region, other sites of involvement are ascending colon, jejunum appendix, duodenum, stomach, esophagus, sigmoid colon. Intestinal tuberculosis presents in three forms, i.e., ulcerative, ulcero-hypertrophic and fibrous (stricture) type. Peritoneal involvement may be present as ascites, loculated, plastic or purulent forms.[1]
Case Report: Reporting a case of 13 yrs. old female patient came with c/o Pain in abdomen for 3 days associated with vomiting 7-8 episodes (Bilious), not passing flatus and motion for 2 days. P/A findings - Distended, tenderness over whole abdomen, Bowel sounds absent, not passing flatus and motion. CECT Whole Abdomen showed infective etiology likely tubercular. Exploratory laparotomy was performed on clinical suspicion of abdominal tuberculosis. 1x1cm perforation was found in proximal ileum. Ileostomy was made.
Conclusion: Tuberculosis is a grave global disease. Emergency surgeons should be familiar with the challenges encountered in diagnosing abdominal tuberculosis. Experienced surgeons may decide for an emergency laparoscopy or laparotomy and may get surprised by the operative and pathological findings confirming the diagnosis. [2]. A study conducted by Dr Bali shows the commonest intraoperative finding encountered was an Ileal perforation followed by multiple small bowel perforations, solitary stricture of the small bowel with perforation, ileo-caecal mass, adhesions or bands, single or multiple strictures, stricture with impending small bowel perforation. [3]

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.725.0165
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