A CASE OF ILEO-COLONIC FISTULA WHICH WAS ASSUMED TO BE CAUSED BY INTESTINAL TUBERCULOSIS

Abstract

65-year-old woman was admitted to the hospital because of intractable lower abdominal pain which had been lasting for nearly two years. There was a history of pulmonary tuberculosis (Tbc) which was successfully treated with anti-Tbc agents at the age of twenty years old. Chest and abdominal X-ray examinations revealed calcified lesions which were presumed healed tuberculotic lesions. Barium enema showed shortening of the ascending colon, distorted cecum with pseudo-diverticula and a fistula formation between the stenotic terminal ileum and transverse colon. Right hemicolectomy including the fistula was performed. The patient recovered without any complications and was discharged from the hospital on 45th postoperative day. Although no histological evidence was obtained, intestinal tuberculosis was strongly suspected as a cause of ileo-colonic fistula in this case. Intestinal tuberculosis is liable to extend on the surface of the intestial wall, but does not tend to reach to the deep organs. It is very rare that the disease forms a fistula between organs. We reviewed previously reported six cases of intestinal tuberculosis with fistula formation in Japan.