A Case Report of Perfornated Intestinal Tuberculosis

Yuma Ebihara¹⁾³⁾, Yasuhiro Suzuki¹⁾, Kazuaki Hazama¹⁾³⁾, Motoo Takahashi¹⁾, Miri fujita²⁾ and Hiroyuki Katou³⁾

¹⁾Department of Surgery, Nippon Corporation Muroran Works Hospital, ²⁾Department of Pathology, Nippon Corporation Muroran Works Hospital, ³⁾Department of Surgery, Hokkaido University School of Medicine

Tuberculosis is slowly being forgotten despite its recently increasing morbidity in Japan. A 54-year-old man reported abdominal pain that increased with muscular defense, but abdominal X-ray revealed free air. Chest X-ray showed infiltrative shadows in both lung fields. Abdominal computed tomography (CT) showed a concentric laminar structure in the cecum. He was deagnosed with perforation of the digestive tract and underwent emergency surgey. Surgical findings showed a cecal mass and more than 20 constrictions in the small intestine with wall thickening and intestinal perforarion due to mycobacterium tuberculosis. A jejunum perforation was resected and anastomosed. Pathological study showed characteristic tuberculous granuloma with caseation necrosis in the intestinal wall and in regional lymph nodes. Aftre surgery, triple therapy with INH, REP, and SM was started but the patient died on the post operative day 1. Autopsy findings showed intestinal tuberculosis with multiple ulcers, pulmonary tuberculosis, and miliary tuberculosis.

Key words
intestinal tuberculosis, perforation, miliary tuberculosis

Reprint requests
Yuma Ebihara Department of Surgery, Hokkaido University School of Medicine N-14 W-5, Sapporo, 060-8638 JAPAN

Accepted
April 25, 2001

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