[Gastrointestinal tuberculosis--case report]

Isolated tuberculosis of gastrointestinal tract is a very rare disease most commonly localized in the ileo-cecal region (over 85% of the cases). The main object of surgical therapy is intraperitoneal tuberculosis (IP-TB), which leads to complications such as bowel obstruction, perforation, fistulation and bleeding. Since gastrointestinal tuberculosis can mimic symptoms found in Crohns' disease and ileocecal cancer, definitive diagnosis can only be obtained by the finding of Mycobacterium tuberculosis in tissue and stool sample as well as by positive microbacterial cultivation. A 35 year old female patient was admitted to surgical ward with clinical and radiological signs of ileus. From personal medical history as well as previous medical documentation we learned that the patient had been treated in 1995 for lung and larynx tuberculosis at Jordanovac Hospital in Zagreb. After preoperative preparation, the patient underwent surgery during which we found numerous stenoses in the region of terminal ileum and cecum. Due to the patient's general condition, surgical treatment was performed in two acts. In the first we established an L-L ileotransverse anastomosis, and in the second we made the resection. The diagnosis was confirmed by histological findings of Mycobaterium tuberculosis in stool and tissue samples as well as in resection material during operation. The early postoperative period proceeded free from complications and after surgical treatment the patient was referred to the Klenovnik Special Hospital for Pulmonary Diseases. On follow up 18 months after the surgery, there were no signs of gastrointestinal involvement.