A Case of Intestinal Tuberculosis with Tuberculous Peritonitis

Akihiko Mizoe, YiQin Lin, Yoshiyuki Sho

Department of Surgery, Yurino Hospital

A 24-year-old woman was admitted to our hospital, complaining of severe right lower abdominal pain. The abdomen was markedly distended. Muscular rigidity and rebound tenderness were elicited. Bowel sounds were not audible. Abdominal plain X-ray film, ultrasonography and CT scanning showed a dilated small intestine and ascites. Under a diagnosis of acute diffuse peritonitis with paralytic intestinal obstruction, an emergency operation was performed. A 5×5 cm firm mass was found in the terminal ileum with swollen mesenteric lymph nodes. Miliary caseous nodules were disseminated on the serosal surface of the ileum. A right hemicolectomy was performed. Histological examination confirmed the diagnosis of intestinal tuberculosis (mixed pattern) with tuberculous peritonitis. It was suspected that the diffuse peritonitis was caused by peritoneal involvement of intestinal tuberculosis. The intestinal tuberculosis was thought to be primary, though a pulmonary lesion appeared postoperatively. Antituberculotic agents are being administered to the patient and the clinical course is being observed.

Key words
intestinal tuberculosis, tuberculous peritonitis

Reprint requests
Akihiko Mizoe Department of Surgery, Yurino Hospital
1155-2 Motomura-go, Togitsu-cho, Nishisonogi-gun, 851-21 JAPAN

Accepted
September 9, 1992

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