A CASE OF TUBERCULOSIS OF THE SMALL INTESTINE CAUSING INTESTINAL PERFORATION DUE TO MYCOBACTERIUM TUBERCULOSIS ON CHEMOTHERAPY

With a decrease in tuberculosis, tuberculosis of the small intestine has become a rare disease recently. We report a case of small bowel tuberculosis causing intestinal perforation during chemotherapy for pulmonary tuberculosis. A 51-year-old man received examination for lower abdominal pain and was found to have active ulcer due to Mycobacterium Tuberculosis just under the Bauhim valve in the ileocecal region. Pulmonary tuberculosis was also noted. Tuberculostatic chemotherapy was started, when the lower abdominal pain was intensified. With a diagnosis of generalized peritonitis, an emergency operation was perfomed. Upon laparotomy, a perforation in the small intestine about 60cm from the terminal ileum was present and generalized peritonitis with transudation of intestinal juice was confirmed. In addition small miliary-sized tubercles were sporadically present on the visceral peritonium. A part of the ileum by 80cm and the ileocecal region were resected. Postoperative course was unevenful. The patient was transferred to another hospital for treatment of tuberculosis. These complications occur uncommonly, but we should be so careful for treatment of Mycobacterium tuberculosis by entertaining these complications.