BACKGROUND: Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon. CASE PRESENTATION: We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum. CONCLUSIONS: We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.
BACKGROUND:Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon. CASE PRESENTATION: We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum. CONCLUSIONS: We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.
Authors: Adrien A Tempia-Caliera; Laszlo Zs Horvath; Arthur Zimmermann; Tibor T Tihanyi; Murray Korc; Helmut Friess; Markus W Büchler Journal: J Surg Oncol Date: 2002-02 Impact factor: 3.454
Authors: B Acea Nebril; A Parajó Calvo; L Taboada Filgueira; F Sánchez González; N Blanco Freire Journal: Rev Esp Enferm Dig Date: 1993-09 Impact factor: 2.086
Authors: D K Brief; B J Brener; R Goldenkranz; J Alpert; V Parsonnet; R Ferrante; J Huston; D Eisenbud Journal: Ann Surg Date: 1991-03 Impact factor: 12.969