scholarly journals A Rare Case of Pneumoperitoneum in Pregnancy: Perforation of Tubercular ileal Ulcer

2021 ◽  
Vol 5 (8) ◽  
pp. 01-04
Author(s):  
Richmond Ronald Gomes
Keyword(s):  
Terminal Ileum ◽  
Wedge Resection ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Tuberculosis Patient ◽  
Free Perforation ◽  
Ileal Perforation ◽  
Migrant Communities ◽  
Inflammatory Bowel ◽  
Anti Tubercular Therapy

The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of intestinal tuberculosis can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. 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. We present a 25 year old 17 weeks primi presented with peritonitis with solitary perforation of terminal ileum with miscarriage of fetus and subsequent surgical wedge resection of ileum and ileo-ileal anastomosis. Histology revealed presence of Langerhan’s cell with caseating granulomatous inflammation. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and responded well. This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.

scholarly journals Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

2017 ◽  
Vol 3 (2) ◽  
pp. 52-54
Author(s):  
Md Aminullah ◽  
Fahmida Akter Rima ◽  
Jamal Abdul Naser ◽  
Farzana Kabir ◽  
Waliullah Fuad ◽  
...  
Keyword(s):  
Lymph Node ◽  
Terminal Ileum ◽  
Histopathological Examination ◽  
Good Condition ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Exploratory Laparotomy ◽  
Excisional Biopsy ◽  
Free Perforation ◽  
Diffuse Abdominal Pain

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

scholarly journals Caecal Perforation from Primary Intestinal Tuberculosis in Pregnancy

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Soe Lwin ◽  
Nina Lau Lee Jing ◽  
Haris Suharjono ◽  
Mardiana binti Kipli ◽  
Tin Moe Nwe ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Case Report ◽  
Preterm Delivery ◽  
Bowel Disease ◽  
Intestinal Tuberculosis ◽  
Right Hemicolectomy ◽  
Migrant Communities ◽  
Inflammatory Bowel ◽  
Caecal Perforation ◽  
In Pregnancy

The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of extrapulmonary TB (EPTB) can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. We present a case of caecal TB in pregnancy, which resulted in caecal perforation, a right hemicolectomy, and severe preterm delivery. The aim of this case report is to discuss the diagnosis of extrapulmonary TB, as well as its subsequent management in pregnancy.

scholarly journals Treatment of intestinal tuberculosis with small bowel perforation: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Daniel Sasse ◽  
Christoph D. Spinner ◽  
Kathrin Rothe ◽  
Jochen Schneider ◽  
Jochen Gaa ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Bowel Disease ◽  
Bowel Perforation ◽  
Good Condition ◽  
Intestinal Tuberculosis ◽  
Lower Abdominal Pain ◽  
Granulomatous Inflammation ◽  
Bowel Habit ◽  
Inflammatory Bowel

Abstract Background Diagnosis of intestinal tuberculosis poses a dilemma to physicians due to nonspecific symptoms like abdominal pain, fever, nausea, and a change in bowel habit. In particular, the distinction between inflammatory bowel disease and intestinal tuberculosis remains challenging. Case presentation A 27-year-old man from Colombia presented with fever, night sweats, and progressive lower abdominal pain. Computed tomography revealed a thickening of the bowel wall with a mesenterial lymphadenopathy, ascites ,and a pleural tumor mass. Histology of intestinal and pleural biopsy specimens showed a granulomatous inflammation. Although microscopy and polymerase chain reaction (PCR) for Mycobacterium tuberculosis (MTB) were negative, empirical MTB treatment was initiated on suspicion. Due to a massive post-stenotic atrophied intestinal bowel, MTB medications were administered parenterally in the initial phase of treatment to guarantee adequate systemic resorption. The complicated and critical further course included an intra-abdominal abscess and bowel perforation requiring a split stoma, before the patient could be discharged in good condition after 3 months of in-hospital care. Conclusions This case highlights the clinical complexity and diagnostic challenges of intestinal MTB infection. A multidisciplinary team of physicians should be sensitized to a timely diagnosis of this disease, which often mimics inflammation similar to inflammatory bowel disease, other infections, or malignancies. In our case, radiological findings, histological results, and migratory background underpinned the suspected diagnosis and allowed early initiation of tuberculostatic treatment.

scholarly journals Synchronic Pulmonary and Intestinal Tuberculosis in an Elderly Patient

2020 ◽  
Vol I (3) ◽  
pp. 40-42
Author(s):  
Tirado-Peraza AI
Keyword(s):  
Elderly Patient ◽  
Mycobacterium Tuberculosis ◽  
Acute Abdomen ◽  
Terminal Ileum ◽  
Elderly Woman ◽  
Intestinal Tuberculosis ◽  
Free Perforation ◽  
Gastrointestinal Tuberculosis

We present the case of an elderly woman who presented to the ER with acute abdomen. During surgery, a free perforation in terminal ileum was found so ileostomy and resection were made. Pathology examination reported intestinal tuberculosis, and plain thorax radiography showed a classic Ghon complex. We present a brief report of this uncommon entity. Keywords: Gastrointestinal Tuberculosis; Mycobacterium tuberculosis Infections; Ileostomy

scholarly journals Clinicopathological study of Ileal perforation: study in tertiary center

2017 ◽  
Vol 4 (2) ◽  
pp. 543 ◽  
Author(s):  
Rangappa Poornima ◽  
K. L. Venkatesh ◽  
Goutham M. V. ◽  
. Nirmala ◽  
Noorulla Hassan
Keyword(s):  
Typhoid Fever ◽  
Terminal Ileum ◽  
Enteric Fever ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Hollow Viscus ◽  
Ileal Perforation ◽  
Tertiary Center ◽  
Nonspecific Inflammation ◽  
Hollow Viscus Perforation

Background: The objective of this study was to evaluate the clinicopathological characteristics in Ileal perforations because of confusion and controversy over the diagnosis and optimal surgical treatment of terminal Ileal perforation -a cause of obscure peritonitis. Perforation of terminal ileum is a cause for obscure peritonitis with severe toxic state, there may be obscured clinical features with resultant delays in diagnosis and adequate surgical intervention.Methods: A prospective study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College and Research Institute over a period of 5 years from June 2011 to May 2015. A total of 136 patients presented in this period with hollow viscus perforation and out of these 64 patients had Ileal perforation alone on exploratory laparotomy. Ileal perforations account for about 20 percent of all cases of hollow viscus perforation. Emergency exploratory laparotomy was done and perforation was identified, edge biopsy was taken in all cases and the perforation was closed in two layers and resection anastomosis was done in stricture with perforation. Histopathological report was reviewed following surgery.Results: A total of 64 patients with Ileal perforation were included in the study of which 52 were males and 12 were females accounting for 81.25 percent and 18.75 percent respectively. The causes for perforation were enteric fever (82.81%), nonspecific inflammation (9.38%), and tuberculosis (7.81%). Simple closure of the perforation (74.58%) and the remaining primary resection and anastomosis were the mainstay of the surgical management.Conclusions: The common pathology of Ileal perforation is Typhoid or Enteric fever, Non-specific ulcer, Tuberculosis and others. Intestinal complications of typhoid fever are quite common in developing countries. Nonspecific inflammation of the terminal ileum was other predominant cause operative findings were similar to that of typhoid fever but no laboratory evidence of the disease was found. Intestinal tuberculosis can mimic many conditions.

scholarly journals Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Irfan Masood ◽  
Zain Majid ◽  
Ali Rafiq ◽  
Waqas Rind ◽  
Aisha Zia ◽  
...  
Keyword(s):  
Small Bowel ◽  
Terminal Ileum ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Common Site ◽  
Free Perforation ◽  
Generalized Peritonitis ◽  
Enteric Perforation

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. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.

Unusual presentation of Crohn’s disease

2021 ◽  
Vol 14 (6) ◽  
pp. e242703
Author(s):  
Kate Edwards ◽  
Karen Yearsley
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Wedge Resection ◽  
Rare Condition ◽  
Unusual Presentation ◽  
Protein Losing Enteropathy ◽  
Inflammatory Bowel ◽  
Alpha 1 Antitrypsin ◽  
Underlying Pathophysiology

A previously well 37-year-old woman attended the emergency assessment unit with symptoms of lethargy, breathlessness and peripheral oedema, whereby initial basic investigations revealed an iron deficiency anaemia and serum hypoalbuminaemia. The patient subsequently had multiple admissions to secondary care over a 2-year period due to worsening peripheral and central oedema. Investigations ruled out non-gastrointestinal causes of serum hypoalbuminaemia, such as renal, cardiac and hepatic failures. Gastrointestinal investigations later revealed raised faecal alpha-1 antitrypsin and small bowel ulceration on capsule endoscopy, with a histological diagnosis of Crohn’s disease made after a small bowel wedge resection. This case describes the unusual presentation of Crohn’s disease displaying symptoms primarily of protein-losing enteropathy, an uncommon and under-recognised consequence of inflammatory bowel disease. A review of current literature and the underlying pathophysiology for this rare condition are discussed, particularly in relation to Crohn’s disease.

scholarly journals Fatal typhoid intestinal perforation in post tubal ligation death with an alleged medical negligence: a rare case report

2018 ◽  
Vol 7 (2) ◽  
pp. 755
Author(s):  
Pankaj Suresh Ghormade ◽  
Ajay Narmadaprasad Keoliya
Keyword(s):  
Typhoid Fever ◽  
Intestinal Perforation ◽  
Rare Case ◽  
Tubal Ligation ◽  
Medical Negligence ◽  
Free Perforation ◽  
Ileal Perforation ◽  
Rare Case Report ◽  
History Of ◽  
Difficult Challenge

Worldwide tubal sterilization is commonly used procedure for family planning method. Tubal ligation by minilaparotomy under local anaesthesia is most commonly used method of female sterilization in India. The death rate after tubal sterilizations is 72/100000 for all procedures and mainly due to general anaesthesia or vascular injuries. Iatrogenic injury to bowel can occur in minilaparotomy tubal ligations if there are dense adhesions of intestines or history of previous surgery. In the present case of interval post tubal ligation by minilaparotomy, fatal ileal perforation due to typhoid fever was detected on autopsy which was confirmed after complete histological and lab investigations. Atypical complications of typhoid fever were also noted. In developing countries, typhoid fever is the leading cause of non-traumatic free perforation of intestine and its incidence ranges from 0.9% to 39%, with a high mortality rate. This is rare case of an alleged medical negligence after surgery; in which deciding factor was cause of intestinal perforation i.e. iatrogenic or natural and it posed a difficult challenge.

scholarly journals Acute Peritonitis: A Rare Complication Revealing Intestinal Tuberculosis

2019 ◽  
Vol 1 (3) ◽  
pp. 15-17
Author(s):  
Sabbah M ◽  
Trad D ◽  
Jemmali C ◽  
Jouini R ◽  
Elloumi H ◽  
...  
Keyword(s):  
Rare Complication ◽  
Intestinal Tuberculosis ◽  
High Morbidity ◽  
Acute Peritonitis ◽  
Life Threatening ◽  
Tuberculosis Diagnosis ◽  
Inflammatory Bowel ◽  
Life Threatening Complication ◽  
Specific Symptoms ◽  
Disease Free

Intestinal tuberculosis diagnosis is often difficult because of non-specific symptoms, miming many other conditions such as malignancy, infectious disease, and inflammatory bowel disease. Free intestinal perforation is an uncommon but life-threatening complication of intestinal tuberculosis, associated with high morbidity and mortality.

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