A Case of Intestinal Tuberculosis Disease with an Intussusception

Hiroaki Ito^{1) 2)}, Shuji Tanaka¹⁾, Hajime Kihara¹⁾, Masaki Hirota¹⁾, Yoichiro Baba³⁾ and Katsuyoshi Hatakeyama²⁾

¹⁾Department of Surgery, Niigata Prefectural Muikamachi Hospital, ²⁾Division of Digestive and General Surgery, Department of Regenerative and Transplant Medicine, ³⁾Division of Molecular and Diagnostic Pathology, Department of Molecular Genetics, Niigata University, Graduate School of Medical and Dental Sciences

A 57-year-old woman reporting right lower abdominal pain was palpated with a mobile fine tumor in the right lower abdomen. Abdominal ultrasonography showed a multiple concentric ring sign, and abdominal computed tomography showed a target sign. Chest radiography showed the cave of the right lung. In emergency surgery, we treated the ileum-ascending colon intussusception by Hutchinson's method. We found a soft nodule 3 cm in diameter at the head of the intussusception elevated toward the lumen and having poor mobility, suggesting that the lesion extended from the mucosa to muscularis propria or deeper. We also found 5 similar nodules and many enlarged lymph nodes and small white nodules near the intestine with intussusception. Pathologically, lymph nodes had agglutinated glanuloma, epithelioid cells, and Langhans giant cells. A sputum test and gastric juice were positive tuberculous germs. Deoxyribonucleic acid and favorite acid bacteria cultivation of lymph nodes were positivity. We reported this as an example of intestinal tuberculosis discovered after intussusception that is an extremely rare complication.

Key words
tuberculosis, intestinal tuberculosis, intussusception

Reprint requests
Hiroaki Ito Department of Surgery, Niigata Prefectural Sakamachi Hospital 589 Shimokajiya, Arakawa Town, Niigata, 959-3193 JAPAN

Accepted
February 26, 2003

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