Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

  • Md Aminullah Senior Medical Officer, Department of Surgery, Dhaka National Medical College, Dhaka
  • Fahmida Akter Rima Lecturer, Department of Pathology, Dhaka Medical College, Dhaka
  • Jamal Abdul Naser Registrar, Department of Surgery, Dhaka National Medical College, Dhaka
  • Farzana Kabir Resident, Department of Surgery, Sir Salimullah Medical College, Dhaka
  • Waliullah Fuad Registrar, Department of Medicine, Dhaka National Medical College, Dhaka
  • Fahria Ahmed Medical Officer, Department of Pathology, Dr. Sirazul Islam Medical College, Dhaka
  • Rezwanul Hoque Professor, Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka
Keywords: Intestinal tuberculosis, spontaneous perforation, mesenteric vasculopathy, surgical treatment

Abstract

A 18 years old boy presented with severe diffuse abdominal pain, constipation, abdominal distention, fever and diagnosed as a case of perforation as free gas noted under both dome of the diaphragm. After resuscitation, exploratory laparotomy was done and diagnosed as a case of multiple spontaneous leaky perforations of jejunum and ileum 25 to 30 cm from duodeno-Jejunal flexure (DJ) up to terminal ileum. Peritoneal toileting and excisional biopsy of the mesenteric lymph node were done. Operative and postoperative period were uneventful. Histopathological examination of the resected lymph node revealed granulomatous inflammation compatible with tuberculosis. Anti-tubercular therapy was started and continued for 6 months. Patient was discharged on the 12th postoperative day in a good condition. At 3 months of follow up the patient was asymptomatic and thriving well. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary.

Bangladesh Journal of Infectious Diseases 2016;3(2):52-54

Downloads

Download data is not yet available.
Abstract
754
PDF
517
Published
2017-08-31
How to Cite
Aminullah, M., Rima, F., Naser, J., Kabir, F., Fuad, W., Ahmed, F., & Hoque, R. (2017). Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report. Bangladesh Journal of Infectious Diseases, 3(2), 52-54. https://doi.org/10.3329/bjid.v3i2.33835
Section
Case Reports