Acute Tuberculous Perforation of the Small Bowell During Antituberculosis Therapy

Seabra, J.; Coelho, H S; Barros, Henrique; Alaves, Oliveira; Gonçalves, Vicente; Rocha-Marques, A.

doi:10.1097/00004836-199306000-00011

Cited by 26 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other bacterial agents, including tuberculosis, have become increasingly recognized as a cause, especially with rising incidence of human immunodeficiency virus (HIV) [37] . Occasionally, free perforation may occur, even during anti-tuberculous therapy for extra-pulmonary tuberculosis [38] . Unfortunately, even with surgical treatment, however, mortality may still result [39] .…”

Section: Other Infectionsmentioning

confidence: 99%

Spontaneous free perforation of the small intestine in adults

Freeman¹

2014

WJG

View full text Add to dashboard Cite

show abstract

Section: Other Infectionsmentioning

confidence: 99%

Spontaneous free perforation of the small intestine in adults

Freeman¹

2014

WJG

View full text Add to dashboard Cite

show abstract

“…It has a poor prognosis with mortality rate higher than 30% [21,22]. Free perforation in intestinal tuberculosis usually occurs in the terminal ileum like our patient [23] and it can occur even in patients during anti tuberculosis therapy [24]. In 90% of the cases, perforation is solitary, but multiple perforations occur in 10-40% of patients and are associated with a poor prognosis, therefore immediate operative intervention is indicated [25].…”

Section: Discussionmentioning

confidence: 99%

Free Perforation of Ileal Tubercular Ulcer- A Case Report and Literature Review

Islam¹

2015

Clin Microbiol

View full text Add to dashboard Cite

Primary intestinal tuberculosis is unusual in North American, European and Caribbean countries. Its diagnosis is often surprising and differentiation from inflammatory bowel diseases is difficult. Intestinal perforation is an uncommon but potentially fatal complication of intestinal tuberculosis. There is no reported case of ileal tubercular ulcer perforation from the Caribbean. We present a 59 year old HIV negative patient presented with peritonitis with solitary perforation of terminal ileum. Histology revealed presence of Langerhan's cell with caseating granulomatous inflammation and culture grew acid fast bacilli. A subsequent Manteaux test was strongly positive. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and it is now over one year, the symptoms have not recurs back again. Keywords: Intestinal tuberculosis; Perforation Case ReportA 59 year old known diabetic, hypertensive male presented with 2/7 history of sudden peri-umbilical pain and vomiting. History revealed that the pain was of sudden onset, peri-umbilical, and aggravated by movement and relieved by lying flat. He had no fever, shortness of breath or night sweats. He denied any history of recent travel or contact with anyone infected with tuberculosis. On examination, he was ill looking, moderately dehydrated, tachycardic (pulse of 120 beat per minute) but his blood pressure and body temperature were within normal range. His abdomen was grossly distended with mild diffuse tenderness, mild guarding but no rebound tenderness. There were sluggish bowel sounds. Digital rectal examination was normal. The white blood cell count was elevated (15.5 × 10 3 /ul) and all other labs within normal limit. Erect chest X-rayrevealed no free air however, a CT scan of abdomen and pelvis with intra-venous contrast revealed free air and free fluid in abdomen. After resuscitation patient was prepared for exploratory laparotomy which revealed a solitary 0.5 to 0.8 cm transverse perforation in the anti-mesenteric border of terminal ileum (Figure 1). There was no evidence malignancy or inflammatory bowel diseases (IBD). There was 200 mls of pus-like fluid in peritoneal cavity with inter-loop abscesses with pus flakes and exudates throughout. Segmental resection and primary anastomosis was performed. Patient had a good post op recovery. His ELISA Test for HIV was negative and serum ESR level was elevated. The chest xray showed no radiological evidence of pulmonary tuberculosis. The tuberculin skin test (Manteaux) was done on post-op day #5. It was strongly positive. Microscopic examination of the ileum revealed trans-mural perforation with presence of Langerhan's cell with caseating granulomatous inflammation consistent with small bowel tuberculosis. Acid fast bacilli stain confirmed the presence of Mycobacterium. The patient was started on anti-tubercular therapy (isoniazid, ethambutol, rifampicin). At one year follow up, he remains symptom free (Figure 2a and 2b).

show abstract

“…20 An increased incidence of perforation has been observed in patients taking anti-tubercular chemotherapy. This is presumably due to a reduced inflammatory response which leads to poor healing of ulcers and a reduced tendency of reinforcement by the mesentery.…”

Section: Discussionmentioning

confidence: 99%

Role of histopathological examination in nontraumatic perforation of colon

Singla

Mahajan²,

Agarwal³

et al. 2012

View full text Add to dashboard Cite

Aim: Nontraumatic perforation of colon is an uncommon cause of peritonitis requiring early surgical intervention. This study was carried out to determine the prevalence patterns of the different etiologies of nontraumatic perforation of colon. Methods and results: A total of 35 patients with segments of colon or perforation margins removed for perforation were included. Most of the perforations occurred in the caecum, of which two were seen at the ileocaecal junction. The commonest cause was infection (amoebiasis :13 cases and tuberculosis : 5 cases) followed by ulcers of non specific ulcers (12 cases). There were three cases of adenocarcinoma causing secondary perforation and one case of idiopathic intestinal gangrene and volvulus each. Conclusion: In tropics, non traumatic perforations of colon most often involves caecal and ileocaecal segment and the most common etiology is amoebiasis.

show abstract

Acute Tuberculous Perforation of the Small Bowell During Antituberculosis Therapy

Cited by 26 publications

References 0 publications

Spontaneous free perforation of the small intestine in adults

Spontaneous free perforation of the small intestine in adults

Free Perforation of Ileal Tubercular Ulcer- A Case Report and Literature Review

Role of histopathological examination in nontraumatic perforation of colon

Contact Info

Product

Resources

About