An Uncommon Case of Chronic Tubercular Appendicitis

Maharjan, Sushna

doi:10.1155/2015/534838

Cited by 8 publications

(9 citation statements)

References 12 publications

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“… 7 , 11 In many reports, appendicular TB was found accidentally during the histopathologic examination of the resected appendix. 10 , 11 , 16 Similarly, in the current case report of perforated tuberculous appendicitis, the disease was found out accidentally during the histopathologic examination of the resected appendix.…”

Section: Discussionsupporting

confidence: 52%

“…Regarding the clinical pictures of perforated tuberculous appendicitis, none of the reported cases had a preoperative diagnosis of tuberculous appendicitis. 7 Some authors, including Maharjan, 10 and Morrison et al 9 reported that patients with tuberculous appendicitis had symptoms consistent with acute appendicitis. 11 , 12 Majority of the cases presented with recurrent episodes of pain at the right iliac fossa, vomiting, 6 vague abdominal pain, occasional history of diarrhea, and a mass in the right iliac fossa.…”

Section: Discussionmentioning

confidence: 99%

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Perforated tuberculous appendicitis: a rare case report

Gonie¹,

Bekele²

2018

IMCRJ

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BackgroundGastrointestinal tuberculosis (TB) accounts for 3% of extrapulmonary TB. Tuberculous appendicitis is a rare type of abdominal TB and is seen in only 0.1%–0.3% of cases. Diagnosis is usually made after histopathologic examination of the appendectomy specimen. In Ethiopia, there had been no previous report of perforated appendicular TB, and to our knowledge, this is the first case report of a patient with perforated tuberculous appendicitis to be presented.Case reportA 22-year-old male patient presented with complaints of severe abdominal cramp, periumbilical pain, nausea, 2 episodes of nonbilious vomiting, as well as high-grade fever. Upon admission, abdominal examination revealed direct tenderness below the umbilicus bilaterally and rebound tenderness over the right lower quadrant of the abdomen. The peritoneal cavity was opened through a lower midline incision, and a perforated appendix at the base was found.DiscussionFrom the resected appendix, a sample biopsy was sent for histopathology, and the histological picture revealed granulomatous caseification lesion in the body of the appendix, but no granulomatous lesions elsewhere in the bowel or omentum. Based on these findings, the final diagnosis of perforated tuberculous appendicitis was made. After surgery, the patient started anti-TB treatment on the fourth postoperative day and continued therapy for 6 months, and marked clinical recovery has been observed to date.ConclusionPerforated tuberculous appendicitis was diagnosed only after histopathologic examination of the resected appendix. Hence, TB, a highly prevalent disease in low-income countries, should always be considered in patients with nonspecific abdominal clinical sign and symptoms. It is also suggested that all specimens from perforated appendicitis be subjected to histopathologic examination.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Perforated tuberculous appendicitis: a rare case report

Gonie¹,

Bekele²

2018

IMCRJ

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“…Thirty four cases of Tuberculous Appendicitis were reported in 27 papers [2] , [9] , [10] , [16] , [17] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] . Baseline characteristics are reported in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Tuberculous appendicitis: A review of reported cases over the past 10 years

Hubbard

Chlysta

2021

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Background Tuberculous appendicitis is a rare extrapulmonary manifestation of tuberculosis without clear summarization or consensus on its management. Data sources Case reports were gathered from several online literature databases by searching terms “tuberculosis”, “tuberculous”, and “appendicitis”. Report eligibility criteria: Cases of appendicitis due to M. tuberculosis identified on operative histology. Exclusion criteria: appendicitis caused by a mycobacterium other than M. tuberculosi s, and appendiceal tuberculosis identified incidentally during procedures for other reasons. Results Thirty four patients were identified. Twenty five patients presented with acute right lower quadrant abdominal pain. Eleven patients described chronic symptoms of tuberculosis (cough, night sweats, or weakness/fatigue). Four patients had a known diagnosis of TB. Seven of 24 cases reported peri-operative chest imaging which demonstrated pulmonary lesions. AFB were present in tissue or fluid samples of 6 patients, and negative in 15 patients. All patients underwent pharmacotherapy on a WHO-recommended anti-tuberculous treatment (ATT) with RIPE or an alternative. The average duration of treatment was 7.2 ± 1.7 months. Limitations Data was gathered from case reports without complete uniformity in diagnostic work-up. The potential for larger scale study is limited due to disease rarity. Conclusions Tuberculous appendicitis cannot be diagnosed prior to histologic evaluation. Several data points may suggest the disease on a clinician's differential diagnosis if they present with a combination of the following: born in a country with endemic tuberculosis; chronic cough, weakness/fatigue, or nausea prior to onset of abdominal pain; pulmonary lesions on chest X-ray; white studding of the mesentery or peritoneum in a young patient; positive AFB stain of abdominal fluid or peritoneal tissue.

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“…Maharajan et al reported that signs and symptoms of patients with TB appendicitis were consistent with acute appendicitis, hence making the diagnosis unconfirmed until the histology reports. 9 …”

Section: Discussionmentioning

confidence: 99%

“…8 Maharajan et al reported that signs and symptoms of patients with TB appendicitis were consistent with acute appendicitis, hence making the diagnosis unconfirmed until the histology reports. 9 Patient's perspective I have always been a healthy individual and I have never been to a hospital for any major illness till this pain started. I had believed it to be something minor issue, however when I was told I need surgery I was a bit skeptical.…”

Section: Discussionmentioning

confidence: 99%

Appendicular tuberculosis: a less encountered clinical entity

Ambekar

Bhatia

2021

BMJ Case Rep

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A 21-year-old female patient presented with vague lower abdominal pain associated with nausea since 2 days. On examination, she was tender in the right iliac fossa. Based on clinical presentation and radiological test finding, she was diagnosed as appendicitis and was subjected for diagnostic laparoscopy and appendectomy. Histopathology proved it to be a tubercular appendix, which is a rarely encountered entity. However, in a country like India, tuberculosis (TB) is highly prevalent; however, TB of appendix is rare and less known.

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An Uncommon Case of Chronic Tubercular Appendicitis

Cited by 8 publications

References 12 publications

Perforated tuberculous appendicitis: a rare case report

Perforated tuberculous appendicitis: a rare case report

Tuberculous appendicitis: A review of reported cases over the past 10 years

Appendicular tuberculosis: a less encountered clinical entity

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