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Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

Irfan Masood1, Zain Majid2, Ali Rafiq1

  • 1General Surgery, Civil Hospital Karachi, Karachi 74200, Pakistan; Dow University of Health Sciences, Karachi 74200, Pakistan.

Case Reports in Surgery
|January 23, 2016
PubMed

Insights

Intestinal tuberculosis can cause free perforation, a rare but serious complication. This case highlights extensive pan-enteric perforation, a unique presentation of intestinal tuberculosis not previously documented.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Free perforation is a severe complication of intestinal tuberculosis.
  • The terminal ileum is the most common site for solitary perforations, occurring in 90% of cases.

Purpose of the Study:

  • To report a rare case of extensive pan-enteric perforation due to intestinal tuberculosis.
  • To highlight an unusual and severe manifestation of intestinal tuberculosis.

Main Methods:

  • Case report of a 25-year-old male presenting with generalized peritonitis.
  • Emergency exploratory laparotomy revealing multiple small bowel perforations.
  • Surgical management including primary closure of perforations and resection with double-barreled ostomy.

Main Results:

  • The patient presented with pan-enteric perforation, involving multiple perforations from the duodenojejunal flexure to the terminal ileum.
  • Surgical intervention involved primary closure and resection with ostomy.
  • This extensive tuberculous perforation is unprecedented in medical literature.

Conclusions:

  • Intestinal tuberculosis can present with extensive, multifocal perforations beyond the typical terminal ileum location.
  • This case underscores the diverse and severe spectrum of intestinal tuberculosis complications.
  • Early surgical intervention is crucial for managing such extensive perforations.

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