A rare cause of faecal peritonitis: jejunal perforation in a patient undergoing treatment for pulmonary tuberculosis

Abstract

Abdominal tuberculosis (TB) is a rare but well-documented cause of faecal peritonitis, occasionally occurring in cases where the diagnosis has been delayed, thus resulting in progressive disease. Frequently occurring in the ileo-caecal region, it requires commencement of anti-tubercular regimen and can necessitate surgical intervention. We present a rare case of faecal peritonitis in a young immuno-competent patient with a perforated jejunal stricture, despite triple therapy for known pulmonary TB.

Abdominal Tuberculosis Complicated by Intestinal Perforation

“…Immigrants from developing countries where tuberculosis is endemic are at increased risk for abdominal TB [ 1 ]. In addition, human immunodeficiency virus, acquired immunodeficiency syndrome, alcoholism, intravenous drug use, steroid therapy, and elderly age are also established risk factors for abdominal tuberculosis [ 1 ]. The peritoneum is most commonly involved in abdominal tuberculosis.…”

Intra-abdominal lymphatic tuberculosis as a rare case of small intestine volvulus

“…9 The laparoscopic evaluation of the peritoneal cavity remains the final invasive diagnostic method. The treatment for extrapulmonary TB involves 6 months of quadruple antitubercular chemotherapy 3 with the exception of TB meningitis for which 9- to 12-month treatment is recommended. 4 The first 2 months of treatment are the intensive phase and the regimen consists of INH, RIF, PZA and EMB, followed by a continuation phase of 4 months of INH and RIF.…”

“…1 The incidence of TB has increased in developed countries due to immune-compromisation from AIDS, increased immigration from developing countries, where the prevalence of the disease is higher, 2 and increased multi-resistant mycobacteria from inappropriate use of antitubercular therapy. 3 Several factors determine the probability of transmission including the infectiousness of the source patients, the host’s susceptibility of contacts, the duration of exposure and the environment in which exposure takes place, especially small, poorly ventilated spaces. 4 TB involves abdomen as a secondary disease emerging from the reactivation of a dormant focus, acquired somewhere in the past, or as a descending disease when infection spreads to the abdomen via swallowed sputum, hematogenous spread, spread from an infected neighboring organ or ingestion of unpasteurized milk.…”