The incidence of tuberculosis (TB) worldwide is still significantly high, with India contributing a high global TB burden. This case study features a 49-year-old male who had complaints of pain and abdominal distention for one and a half months. An erect abdominal radiograph showed features suggesting small bowel obstruction. Contrast-enhanced computed tomography (CT) of the abdomen was done. It showed multiple strictures involving the distal jejunum and ileum, causing small bowel obstruction. There was mesenteric and retroperitoneal lymphadenopathy with central necrosis and ascites. The patient was operated on for a small bowel obstruction. The resected intestine showed four strictures, tiny nodules on the serosal surface, and many enlarged lymph nodes. Representative tissue from these areas showed the typical picture of multiple caseating granulomas and fibrosis. Ziehl-Neelsen (ZN) staining highlighted the acid-fast bacilli (AFB). The suspicion index for intestinal tuberculosis (ITB) should be kept high while evaluating patients with intestinal obstruction presenting in endemic areas and high-risk populations, such as HIV-infected, undernourished, immunocompromised, and those with diabetes, smoking, and alcohol addiction.

暂无摘要。

Abdominal tuberculosis (ATB) constitutes 12% of the extra pulmonary disease and is a rare but well-documented cause of perforation peritonitis, occasionally occurring in cases where the diagnosis has been delayed but may occur even after antituberculous therapy has been initiated. Most patients with tuberculosis strictures respond well to medical treatment and should be resorted to surgery only if drug therapy fails. Despite surgical intervention, tuberculosis perforation has a high complication and mortality rate. We present a case of 54-year-old male patient with a perforated jejunal stricture who had completed his treatment for pulmonary tuberculosis one month earlier. This case was unusual because of the age of patient at presentation (usually seen in young - 25 to 45 y), involvement of jejunum (commonly ileocaecal region), initial presentation with subacute obstruction followed by peritonitis (refused treatment at first instance) and patient having completed treatment for pulmonary tuberculosis recently.