Tuberculosis Enteritis Presenting as a Small Bowel Obstruction

Abstract

c i T s c f o r g c w c E 25-year-old healthy Indian woman presented with feer, chills, night sweats, nausea, vomiting, abdominal istention, and severe abdominal pain for 2 days. She ad intermittent abdominal pain and 60-pound weight oss for the 6 months since her arrival from India. On xamination she was afebrile, tachycardic, and had a oft, distended abdomen with diffuse tenderness, reound, and guarding. A chest x-ray showed no abnoralities. CT scan of the abdomen showed high-grade bstruction (A) with the transition point at the ilealecal region and lymphadenopathy. There was an abnorally thickened cecum (B). The patient had leukocytois of 20,000 and 47% bandemia. Because her bdominal examination worsened, she was taken to the perating room to relieve the obstruction. Our differenial diagnosis was high-grade small bowel obstruction rom previous perforated appendicitis with abscess foration, a malignant lymphoma, or tuberculosis. At laprotomy, a phlegmous process involving part of the ce-