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A Case Report and Literature Review of Intestinal Perforation Due to Tuberculosis

Angie E Vargas Rodríguez¹, Ansony R Godinez Vidal¹, Raymundo Alcántara Gordillo²

¹Surgery, General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, MEX.

|September 11, 2023

Abstract:

Intestinal tuberculosis (ITB) is challenging due to its nonspecific clinical presentation, sometimes manifesting with acute complications such as intestinal perforation or obstruction. We present the case of a 39-year-old male presented with continuous fever, abdominal pain, and peritoneal irritation. A contrast-enhanced thoracoabdominopelvic computed tomography revealed free air and fluid, suggestive of intestinal perforation. Urgent surgical treatment was performed via exploratory laparotomy, including right hemicolectomy and construction of a Brooke ileostomy. Histopathological analysis confirmed intestinal miliary tuberculosis. The most commonly affected areas in ITB are the ileocecal region and ileum. Symptoms include abdominal pain, weight loss, changes in bowel habits, and fever. Contrast-enhanced computed tomography is crucial for diagnosis. The first-line treatment is medical with antituberculosis drugs. Due to its delayed diagnosis, ITB should be considered in patients with nonspecific and progressive symptoms. Early medical management is crucial to prevent acute complications associated with high morbidity and mortality.

Keywords:

abdominal pain acute presentation extrapulmonary tuberculosis intestinal perforation

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