A CASE OF SOLITARY ILEAL TUBERCULOSIS WITH MULTIPLE STENOSIS

A 35-year-old man was admitted because of nausea and abdominal pain. There was no surgical and particular familial history. Laboratory data and gastrointestinal roentogenography could not point out any specific abnormality on that time. He was discharged home after those symptoms had disappeared by conservative treatment. Seven months later, he was re-hospitalized with recured similar symptoms. Intestinal obstruction due to an ileal tumor was diagnosed by small bowel enema. Swelling of mesenterial lymphnodes and many white small nodules scattered on the peritoneum were shown at laparotomy. Resection of right hemicolon involved stenotic ileum was performed. Multiple focus with two ringed stenosis were shown in the specimen and tuberculosis was diagnosed histologically. After antituberculous chemotherapy, he was discharged home without any symptoms. Intestinal tuberculosis accompanying by no lesion in the lung is called solitary intestinal tuberculosis. Surgery can be indicated for the disease in its curative phase when intestinal obstruction is often associated. On operation we should make every effort to define the diagnosis as soon as possible, with intraoperative frozen section to avoid oversurgery.