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Ileal perforation in a child with abdominal tuberculosis
1Pediatric TB Clinic, B. J. Wadia Hospital for Children, Mumbai, India. irashah@pediatriconcall.com
Annals of Tropical Paediatrics
|September 11, 2010
Summary
A rare case of intestinal obstruction in a child was diagnosed as ileal perforation caused by tuberculosis. This condition, though common in adults, is exceptionally uncommon in pediatric patients.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Tuberculosis (TB) is a significant global health issue, primarily affecting the lungs but also capable of causing extrapulmonary manifestations.
- Intestinal tuberculosis is a known complication of Mycobacterium tuberculosis infection, often presenting with non-specific symptoms.
- Ileal perforation due to tuberculosis is well-documented in adults, but exceedingly rare in the pediatric population.
Observation:
- A 6-year-old boy presented with a month-long history of fever, followed by acute abdominal distension, constipation, and bilious vomiting.
- Initial clinical assessment suggested intestinal obstruction as the primary diagnosis.
- Exploratory laparotomy revealed ileal perforation as the cause of the obstruction.
Findings:
- Histopathological examination confirmed the ileal perforation was secondary to tuberculosis.
- The rarity of tubercular ileal perforation in children was noted, contrasting with its higher incidence in adults.
Implications:
- This case highlights the importance of considering tuberculosis in the differential diagnosis of intestinal obstruction in children, even in low-prevalence settings.
- Early recognition and surgical intervention are crucial for managing pediatric intestinal perforation due to tuberculosis.
- Further research into the unique presentation and management of pediatric intestinal TB is warranted.
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