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 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 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.

scholarly journals Bilateral ovarian dysgerminoma with metastasis in female dog's mesenteric lymph node: a case report

2021 ◽  
Vol 1 (2) ◽  
pp. 32-41
Author(s):  
Edgar Tavares de Assis-Neto ◽  
Daniel de Araújo Viana ◽  
Márcio César Vasconcelos Silva
Keyword(s):  
Lymph Node ◽  
Histopathological Examination ◽  
Present Report ◽  
Malignant Neoplasm ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Incisional Biopsy ◽  
Mesenteric Lymph ◽  
Chemotherapy Protocol ◽  
Ovarian Dysgerminoma

Dysgerminoma is a rare malignant neoplasm, associated with hormonal dysfunctions, which occurs in canine and feline females from middle age to elderly, without racial predisposition. In the present report, we described a case of ovarian dysgerminoma in a dog, only abdominal distension, persistent vulvar bloody discharge and apathy. The animal in question underwent exploratory laparotomy, where general neoformations were detected in the ovaries, and a lymph node with abnormal characteristics was also found. Therefore, surgery for ovariosalpingoisterectomy and puncture of a fragment of the lymph node altered for incisional biopsy was performed. The diagnosis was made through histopathological examination of the ovaries of the fragment derived from the lymph node, the result of which indicated the presence of dysgerminoma in both ovaries and in the lymph node, characterizing a metastasis. In view of this result, the chemotherapy protocol with the association of carboplatin and vinblastine was instituted, which proved to be effective and not very toxic to the animal, with no clinical sign of metastasis being identified after its use.

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 ILEOSCOPY

2015 ◽  
Vol 22 (03) ◽  
pp. 327-332
Author(s):  
Muhammad Mansoor ul Haq ◽  
Ayesha Khalil ◽  
Hafeezullah Shaikh ◽  
Shahid Mahmood ◽  
Kailash Makhijani
Keyword(s):  
Weight Loss ◽  
Terminal Ileum ◽  
Histopathological Examination ◽  
Diagnostic Yield ◽  
Granulomatous Inflammation ◽  
Normal Mucosa ◽  
Chronic Diarrhoea ◽  
Histopathological Analysis ◽  
Aged Patients ◽  
Medical College

Colonoscopy is one of the most important modalities to investigate complaintsrelated to lower gastrointestinal tract. Terminal ileum is an essential part of the completecolonoscopic examination. Objectives: To observe the diagnostic yield of ileoscopy in patientsundergoing colonoscopy. Design: Retrospective and observational study. Period: January 2010to May 2014. Setting: Liaquat National Hospital and Medical College. Patients and methods:Patients undergoing colonoscopy fulfilling inclusion and exclusion criteria were enrolled.Terminal ileum was examined and biopsies taken if abnormality present. Statistical analysiswas done by SPSS- 18. Result: A total of 1296 patients were included, 884 (68.2%) were maleand 412 (31.8%) were female. Age ranged from 15-90 years. The commonest indication wasbleeding per rectum (35.6%).1133(87.4%) patients had normal mucosa and 163 (12.6%) hadabnormal mucosa on ileoscopy. Of these 163 patients, 68 had ulcers, 56 had inflammation, 29had nodular mucosa and 10 had polyp. Histopathological examination showed non-specificinflammation in 139 patients; granulomatous inflammation in 7; reactive lymphoid hyperplasiain 8; 3 had normal result; biopsies were not taken in remaining 6 patients. By using chi-squaretest we found a significant statistical relationship between macroscopic abnormality of terminalileum mucosa and age of patients, weight loss, chronic diarrhoea, and abdominal pain. Onlogistic regression, age group, chronic diarrhoea and weight loss retained strong relationshipwith macroscopic abnormality of terminal ileum mucosa. Conclusions: Though a large numberof patients (12.6%) had abnormal terminal ileum mucosa, histopathological analysis did notshow any significant yield of ileoscopy. Terminal ileal abnormality was more common in youngand middle aged patients and in patients presenting primarily with chronic diarrhoea andweight loss.

scholarly journals Abdominal Tuberculosis: A Histopathological Study with Special Reference to Intestinal Perforation and Mesenteric Vasculopathy

2009 ◽  
Vol 1 (02) ◽  
pp. 056-061 ◽  
Author(s):  
Alakananda Dasgupta ◽  
Navjeevan Singh ◽  
Arati Bhatia
Keyword(s):  
Histopathological Examination ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Abdominal Tuberculosis ◽  
Epithelioid Cell ◽  
Histopathological Study ◽  
Ulcer Formation ◽  
Microscopic Features ◽  
History Of ◽  
One Year

ABSTRACT Background: Along with the increased incidence of pulmonary tuberculosis in parallel with the increase in population in various parts of the world, in recent years, the incidence of abdominal tuberculosis has also increased. The pathogenetic events in intestinal tuberculosis, which culminate in ulcer formation, perforation, and stricture, still have to be identified. Aim: To correlate the gross and microscopic features in intestinal tuberculosis, in particular tuberculous perforation with changes in mesenteric vasculature. Patients and Methods: A one-year prospective study of excised/resected tissues from patients with abdominal tuberculosis requiring surgical intervention was conducted. Tissues from fifty-six patients were included in the study — of which 36 were resected intestinal segments and 20 were intestinal and lymph node biopsies. Hematoxylin and Eosin and Ziehl-Neelsen stains were used for histopathological examination. Results: Tuberculous enteritis was found to be present in 49 of the 56 patients (87.5%) (ileum being the site most commonly affected), while nodal involvement was seen in 39 (69.6%) patients. Perforations were present in 39 out of 49 (79.6%) intestinal tissues; most being solitary and ileum was the commonest site. Typical epithelioid cell granulomas were seen in the intestine and lymph nodes, with caseation being more prevalent in the latter. The mesenteric vasculature was frequently involved by granulomatous inflammation, with intravascular organizing thrombus being present in 30% of the resected specimens with perforation. Acid fast bacilli were demonstrated in the tissue sections of 37.5% of the patients. AFB positivity was higher in caseating granulomas. Conclusion: Involvement of mesenteric vasculature by granulomatous inflammation was commonly associated with the ulcerative type with perforation, suggesting that ischemia caused by vascular thrombosis is responsible for tissue breakdown. This implies that vasculitis plays an important role in the natural history of abdominal tuberculosis.

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 A Case Report of Unicentric Castleman Disease

2015 ◽  
Vol 23 (2) ◽  
pp. 256-258
Author(s):  
Mafruha Akter ◽  
Ibrahim Khalil ◽  
Golam Nabi ◽  
Syed Zakir Hossain ◽  
Md Uzzwal Mallik ◽  
...  
Keyword(s):  
Lymph Node ◽  
Plasma Cell ◽  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Good Prognosis ◽  
Castleman Disease ◽  
Angiofollicular Lymph Node Hyperplasia ◽  
Human Herpes Virus 8 ◽  
Medical College

Castleman disease (CD) or angiofollicular lymph node hyperplasia is an uncommon benign lymphoproliferative disorder. Sometimes it is related to the chronic human herpes virus 8 (HHV-8) infection and the human immunodeficiency virus (HIV). Two clinical entities have been described: a unicentric presentation with the disease confined to a single anatomic lymph node and a multicentric presentation characterized by generalized lymphadenopathy and a more aggressive clinical course. Also, three histopathological subtypes have been described: hyalinevascular, plasma cell, and a mixed variant.We report the case of a 22-year-old young man who was diagnosed as unicentric Castleman Disease. We found on routine physical examination a mass localized in the left abdomen without clinically important constitutional symptoms for 3 years. Abdominal ultrasound and computed tomography scans revealed minimally enhancing soft tissue density lesion & it was seen in the left para aortic region measuring about 71mm x 42 mm in size. The patient subse-quently underwent an exploratory laparotomy. After opening of the abdomen, a lump measuring about 8 cm x 5 cm was found in the mesentery. The whole lump was dissected out and the gap in the mesentery was closed. No other lymphadenopathy was found. The specimen was sent for histopathology which revealed Castleman disease, plasma cell type. The patient completely recovered after surgery. Castleman disease is commonly misdiagnosed as malignant lymphoma, lymphadenitis or ectopic thymoma. So far, its diagnosis is mainly achieved via histopathological examination of surgically obtained tissue. Local or unicentric CD has a good prognosis if surgically excised properly.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 256-258

scholarly journals Synthetic Fiber Granuloma Misdiagnosed as Chalazion in an 8-year-old Child

2021 ◽  
Vol 62 (7) ◽  
pp. 993-997
Author(s):  
Jae Hong An ◽  
Hye Ra Jung ◽  
Jong Hwa Jun
Keyword(s):  
Histopathological Examination ◽  
Granulomatous Inflammation ◽  
Excisional Biopsy ◽  
Synthetic Fiber ◽  
Medical Illness ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Trauma History ◽  
Palpebral Conjunctiva ◽  
Detailed Medical History

Purpose: We report a case of conjunctival synthetic fiber granuloma, which was misdiagnosed as chalazion. Case summary: An 8-year-old female patient, without any previous medical illness or ocular trauma history, visited our hospital with a prolonged mass-like lesion in the left lower palpebral conjunctiva. In her detailed medical history, she said that she often played with her doll's hair. The conjunctival mass first occurred 1 week before her visit to the private clinic. At that time, eye drop treatment was initiated under the diagnosis of chalazion. The child showed no improvement; thus, incision and curettage were performed. The mass in the conjunctiva continued to persist, so she was transferred to the hospital for a biopsy. Slit-lamp examination revealed a patterned agglomeration of fiber strands inside the mass. Complete excisional biopsy was performed under general anesthesia. Histopathological examination revealed a fibrous foreign body in the birefringence, with granulomatous inflammation surrounding it. The patient was diagnosed with synthetic fiber granuloma. Conclusions: Conjunctival synthetic fiber granulomas are easily mistaken as chalazion. If specific fibrous strands are entangled inside the mass on slit-lamp examination, diagnosis and treatment through therapeutic excisional biopsy are required under clinical suspicion.

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