A Case of Mesenteric Tuberculosis Presenting Dificulties in Differentiation from Abdominal Tumor

Kaichirou Kikuchi, Syuhei Iida

Department of Surgery, Nerima General Hospital

Tumor-forming abdominal tuberculosis is rare disease that sometimes presents difficulties in diagnosis. This is a report of a patient with mesenteric tuberculosis that was difficult to differentiate from an abdominal tumor and was diagnosed by exploratory laparotomy. The patient, a 24-year-old Philippine woman, had a tender, egg-sized abdominal tumor slightly left of the umbilicus. She had no previous history of pulmonary tuberculosis, which was found in her parents' history. CT and ultrasonography revealed numerous widespread tumors 1∼4 cm in diameter, presumably originating from the mesentery, while no abnormalities were detected by gastrointestinal tract study and abdominal angiography. An exploratory laparotomy, performed because no definitive diagnosis could be made, revealed minimal ascites and no adhesions in the abdominal cavity. There were numerous yellow markedly enlarged lymph nodes, irregular in size, throughout the mesentery of the small intestine. Because of evidence of tubercle bacillis in the biopsied lymph nodes, administration of anti-tuberculosis agents was started. It should be kept in mind that some patients with abdominal tuberculosis may present with markedly enlarged lymph nodes.

Key words
mesenteric mass, tuberculous lymphadenitis of mesentery

Reprint requests
Kaichirou Kikuchi Department of Surgery, Nerima General Hospital
2-41 Asahigaoka, Nerima-ku, Tokyo, 176 JAPAN

Accepted
March 13, 1991

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