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Published on: September 22, 2019
Isolated jejunal tuberculosis presenting as chronic intestinal obstruction.
Supriya Adiody1, Joseph T K2, Vishnu Narayanan S3
1Respiratory Medicine, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India adiodysupriya337@gmail.com.
BMJ Case Reports
|July 2, 2026
Summary
Isolated jejunal tuberculosis is rare but should be considered for unexplained small bowel strictures. Early diagnosis and treatment with standard antitubercular therapy lead to good clinical response, even with negative initial tests.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Abdominal Surgery
Background:
- Intestinal tuberculosis (TB) typically affects the ileo-caecal region.
- Isolated jejunal TB without ileo-caecal or colonic involvement is exceptionally rare.
- Small bowel obstruction can be a presenting feature of intestinal TB.
Purpose of the Study:
- To report a rare case of isolated jejunal tuberculosis presenting as small bowel obstruction.
- To emphasize the importance of considering TB in endemic regions for unexplained small bowel strictures.
- To highlight diagnostic challenges and treatment outcomes in such cases.
Main Methods:
- Case report of a woman in her early 60s with a 2-year history of vague abdominal symptoms.
- Diagnostic workup included contrast-enhanced CT, enteroscopy, and ileo-colonoscopy.
- Surgical intervention involved laparoscopy-assisted segmental jejunal resection.
- Histopathology confirmed necrotising epithelioid granulomatous inflammation consistent with TB.
- GeneXpert MTB/RIF assay was negative.
Main Results:
- The patient presented with symptoms suggestive of small bowel obstruction.
- CT revealed a short-segment jejunal stricture.
- Histopathology confirmed intestinal TB.
- Despite a negative GeneXpert MTB/RIF assay, standard antitubercular therapy was initiated.
- The patient showed a good clinical response to treatment.
Conclusions:
- Isolated jejunal TB is a rare but important differential diagnosis for small bowel strictures, particularly in TB-endemic regions.
- Diagnostic modalities like enteroscopy and histopathology are crucial for diagnosis.
- Prompt initiation of antitubercular therapy can lead to favorable outcomes, even with negative molecular tests.
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