Free tubercular perforation of the ileum

Abstract

BACKGROUND:Peritonitis secondary to small bowel perforation is a common surgical emergency seen across the globe.METHODS:A young male patient presented with ileal perforation that was repaired primarily. He recovered uneventfully after the operation.RESULTS:Histopathology of the margins of the perforation revealed tuberculosis. A search for evidence of a primary focus of tuberculosis was unsuccessful. The patient was started on anti- tubercular therapy and he was followed up with good results.CONCLUSION:This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.

Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

“…Abdominal tuberculosis is common in Bangladesh and India, more in young 1,4 . Perforation with peritonitis develops in 5% of patients, usually in ileum 2,4-6 .…”

“…Primary intestinal tuberculosis caused by the bovine strain has become rare 4 . The tubercle bacillus is protected against digestion in the stomach by its fatty capsule and infecting the ileum, jejunum and duodenum 4 . The abundance of lymphoid tissue, stasis and minimal digestion of the bacteria are possible reasons for the high incidence of tuberculosis in the ileum 4,7 .…”

“…The tubercle bacillus is protected against digestion in the stomach by its fatty capsule and infecting the ileum, jejunum and duodenum 4 . The abundance of lymphoid tissue, stasis and minimal digestion of the bacteria are possible reasons for the high incidence of tuberculosis in the ileum 4,7 . The hypertrophic form usually occurs in the ileum about 70% cases due to fibroblastic reaction to the tubercle bacilli 4 .…”

“…Such an extensive perforation of the small bowel has not been previously reported in the literature. Intestinal tuberculosis can occur both primary and secondary to a tuberculous focus at different sites 4 . Primary intestinal tuberculosis caused by the bovine strain has become rare 4 .…”

“…Intestinal tuberculosis can occur both primary and secondary to a tuberculous focus at different sites 4 . Primary intestinal tuberculosis caused by the bovine strain has become rare 4 . The tubercle bacillus is protected against digestion in the stomach by its fatty capsule and infecting the ileum, jejunum and duodenum 4 .…”