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Primary tubercular caecal perforation: a rare clinical entity.
Devendra K Jain1, Gaurav Aggarwal, Parvinder S Lubana
1Department of Surgery, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India.
BMC Surgery
|April 2, 2010
Summary
A rare case of intestinal tuberculosis presented as a caecal perforation. This case highlights the importance of considering tuberculosis in patients with perforation peritonitis, especially in endemic regions.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Intestinal tuberculosis (IT) is a significant global health concern, prevalent in endemic regions.
- IT commonly causes substantial morbidity and mortality.
- Isolated primary caecal perforation due to tuberculosis is an extremely rare clinical presentation.
Observation:
- A 39-year-old male presented with symptoms of perforation peritonitis.
- Laparotomy revealed a caecal perforation with a compromised appendix.
- A right hemicolectomy with ileostomy was performed.
Findings:
- Histopathology confirmed transmural caseating granulomas with characteristic features of tuberculosis.
- Acid-fast bacilli were identified in the caecal tissue.
- Tuberculosis was localized exclusively to the caecum.
Implications:
- This case underscores the need to consider primary caecal tuberculosis in the differential diagnosis of caecal perforations.
- Increased global incidence of tuberculosis necessitates heightened awareness of its diverse presentations.
- Early recognition and diagnosis are crucial for effective management and improved patient outcomes in rare forms of intestinal tuberculosis.
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