1/243. Richter's hernia: a rare presentation of abdominal tuberculosis. intestinal obstruction due to Richter's hernia has not been reported in abdominal tuberculosis. This 21-year-old man with abdominal tuberculosis presented with small gut obstruction due to Richter's hernia associated with ascites and patent right processus vaginalis (PV). He underwent laparotomy with reduction of Richter's hernia and closure of the PV at the right deep inguinal ring. ( info) |
2/243. Generalized AA-amyloidosis in a 58-year-old Caucasian woman with an 18-month history of gastrointestinal tuberculosis. We report on a 58-year-old Caucasian woman who went to a general practitioner about recurrent abdominal pain, night sweats and weight loss of a few weeks' duration. Once gynaecological disease had been ruled out, the patient was admitted to hospital with severe abdominal pain and intestinal obstruction and a right-sided hemicolectomy was performed. Following the investigation of osteolytic lumbar vertebrae, 18 months after visiting the general practitioner the patient was finally found to be suffering from generalized AA-amyloidosis secondary to gastrointestinal tuberculosis. This had been misinterpreted as Crohn's disease. Re-examination of the specimens from the right-sided hemicolectomy demonstrated that scanty deposits of AA-amyloid were present 9 months after the first presentation. AA-amyloid can thus be present in serious inflammatory disease even during the first 9 months after the initial clinical presentation. ( info) |
3/243. Duodenal tuberculosis as seen by duodenoscopy. A case of tuberculous stricture of the third part of the duodenum was detected by duodenoscopy. Endoscopic biopsy, however, failed to reveal the histological diagnosis. The possible role of endoscopic follow-up of tubercular strictures is indicated. ( info) |
4/243. Multiple tubercular ulcer perforation of ileum in an AIDS patient: case report. intestinal perforation is an extremely uncommon complication of mycobacterium tuberculosis (MTB) infection. We report a case of hiv infection in a male injecting drug user (IDU) with intestinal tuberculosis complicated with multiple ileal perforations at the Regional Institute of Medical Sciences Hospital, Imphal, Manipur. The emergency surgical therapy supported by antitubercular drugs (ATT) and parenteral nutrition saved the life of this patient who presented in a critical state of shock. The patient manifested with extrapulmonary tuberculosis, which is one of the criteria of AIDS. The authors stress the possibility that in future, tubercular complication till now considered atypical, may become more frequent. ( info) |
5/243. Isolated colonic tuberculous perforation as a rare cause of peritonitis: report of a case. We present herein the rare case of a patient who developed peritonitis due to colonic tuberculosis with perforation. The patient was successfully treated by resectional surgery with delayed restoration of bowel continuity and antitubercular therapy. ( info) |
6/243. Isolated gastric tuberculosis of the cardia. BACKGROUND: Isolated gastric tuberculosis is extremely rare, especially in the subcardiac region, where the low pH, high motility and absence of lymphoid tissue result in an unfavourable environment for the development of tuberculous lesions. methods AND RESULTS: Here we present a case of isolated gastric tuberculosis in the gastric cardia with no evidence of pulmonary involvement. Our patient was a young man with vague gastrointestinal symptoms and no previous history of tuberculosis. His condition was first detected on upper endoscopy as a raised subcardiac ulcer similar in appearance to a submucosal tumour. An endoscopic forceps biopsy showed the presence of caseating granulomata and acid-fast bacilli. The lesion resolved completely with 12 months of oral anti-tuberculosis therapy. CONCLUSIONS: This case illustrates the need for a high index of suspicion in order to diagnose this rare condition, as it can present in patients with no particular risk factors or symptoms. Once diagnosed, a complete cure can often be achieved with a course of oral anti-tuberculosis medication, with surgery being reserved for severely symptomatic or refractory lesions. ( info) |
7/243. Gastric tuberculosis: unusual presentations in two patients. We report two cases of gastric tuberculosis (TB) in Nigerians. The first case concerns an elderly man initially thought to have abdominal malignancy but was subsequently found to have extensive and complicated gastric TB coexisting with chronic peptic ulcer disease. The second case involved the extremely rare condition of gastro-bronchial fistula in a young woman. In contrast to previously reported cases, it was of tuberculous origin and pulmonary symptoms were minimal. Both cases were radiologically evident. ( info) |
8/243. Perianal disease of tuberculous origin: report of a case and review of the literature. PURPOSE: A case of anal tuberculosis in an otherwise asymptomatic patient with bleeding anal ulcers is presented. The clinical features of this entity and the problems in differential diagnosis between anal infectious vs. inflammatory diseases are discussed. methods: The management and outcome of the case of an adult patient who presented with perianal ulcers is described. RESULTS: On a three-drug antituberculous regimen, symptoms abated, radiographic infiltrates improved, and perianal ulcers healed. CONCLUSION: Anal tuberculosis is an extremely rare disease. A tuberculous origin must be considered when the cause of perianal ulcers is unclear to avoid undesirable delays in the diagnosis and treatment of this disease. ( info) |
9/243. Massive rectal bleeding due to jejunal and colonic tuberculosis. A case of massive rectal bleeding due to colonic tuberculosis in advanced pregnancy with intrauterine foetal death is reported. Patient was treated with resection of the left colon and left transverse end colostomy with closure of the rectal stump. hysterotomy for the removal of the dead foetus was performed. The patient improved in health with antitubercular treatment. The colorectal anastomosis was performed after 4 months. Massive rectal bleeding in intestinal tuberculosis, though rare should be kept in mind. ( info) |
10/243. An unusual case of ileocaecal tuberculosis in an 80-year-old Caucasian male. An 80-year-old Caucasian male presented with a seven-week history of diarrhoea and weight loss. Distal duodenal biopsies showed partial villous atrophy but he failed to respond to a gluten-free diet. Subsequently he developed a right iliac fossa mass associated with radiological evidence of ileocaecal ulceration. Colonoscopic biopsies from the caecum showed non-caseating granulomata and Ziehl-Neelsen (ZN) staining and culture for acid-fast bacilli (AFB) were negative. Crohn's disease was diagnosed and he was started on steroids. Although he showed an initial response, his condition then deteriorated and he died after six weeks. ZN staining of tissue at postmortem showed AFBs. Although a rare diagnosis in the UK, a high index of suspicion should be maintained for ileocaecal TB in patients with appropriate clinical features, even if classical risk factors for TB are absent. ( info) |