ABDOMINAL TUBERCULOSIS PRESENTING AS INTUSSUSCEPTION

Abstract

Intestinal obstruction is a rare adult entity that behaves differently from its paediatric counterpart because of underlying pathological landmarks, most commonly neoplasms. The main clinical manifestation of chronic intussusception in adults remains dull abdominal pain. Computed tomography remains the diagnostic method of choice and surgical resection is the treatment of choice. Here is one such case of chronic intussusception of a 59 year old man presenting with abdominal distension and vomiting for 20 days. Evaluation revealed an intestinal obstruction and the patient was admitted for an emergency laparotomy. Intra-operatively ileo-ileal intussusception was noted with lymph node as the lead point. Since the intestine was gangrenous and the haemodynamics of the patient was unstable during the operation, and there was a strong suspicion of abdominal tuberculosis, so the small bowel was resected and a stoma was created. Postoperatively the patient were started on anti tuberculous drugs based on histopathological reports. Only about 5% of all cases of intussusception are believed to occur in adults. Adults often present with a vague history of symptoms such as diarrhoea, constipation, and weight loss, in contrast to typical childhood symptoms such as acute onset, episodic abdominal pain, currant-jelly stools, and vomiting. In one study, 30% of his adults had intussusception. The most common benign cause of intussusception was postoperative adhesions. Limited resection with intestinal anastomosis was often performed in benign intussusception. Abdominal tuberculosis as a cause of ileo-ileal intussusception is poorly described in the scientic literature