Abstract
Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.
Highlights
Intestinal tuberculosis is a disease of underdeveloped countries
Intestinal TB is generally a disease of underdeveloped countries; due to an increase in the number of immigrants as well as HIV-infected patients, the incidence of intestinal TB is rising in the Western countries [1]
Free perforation is a complication of severe untreated disease, occurring in 1–15% of patients with intestinal TB [3, 4]
Summary
Intestinal tuberculosis is a disease of underdeveloped countries. The incidence is increasing in the Western countries due to increased influx of immigrants as well as increased incidence of HIV infection and increased use of immunosuppressive drugs. Perforation is an uncommon but life-threatening complication of intestinal TB, associated with high morbidity and mortality. We describe a patient who developed acute tuberculous pan-enteric perforation. Such a manifestation of intestinal TB has not been previously reported in the literature
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