A CASE OF INTESTINAL TUBERCULOSIS PRESENTING WITH ILEUS

A 75-year-old female was admitted to the hospital because of a right-sided abdominal pain, distension and their recurrence. The patient repeated vomiting caused by intestinal obstruction. Double contrast radiography showed characteristic findings of intestinal tuberculosis with scarred area and deformed intestinal lumen in the cecum and in the right-sided colon. Colonoscopy showed circular, girdle-like ulcer, pseudo-diverticulum and inflammatory polyps. Intestinal tuberculosis was highly suspected, but was not confirmed by biopsy specimens. Right hemicolectomy was performed because of repeated intestinal obstruction and of being afraid of aggravation of small intestinal lesion by antituberculosis. Histopathological study demonstrated characteristic tuberculous granuloma with caseation necrosis in the intestinal wall as well as in the regional lymph nodes. The patient has been treated with antituberculosis chemotherapy and free from recurrence, as of one year after the operation.