<原著>原発性腸結核 : 虫垂切除後難治瘻孔形成の1例

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A 22-year-old male complaining of the persistent enterocutaneous fistula complicated after appendectomy was re-explored. There was granulomatous change along the fistulous tract in the ileocecal region. The jejunum and ileum showed multiple, granular nodules over their mucosal and serosal surfaces. Ileocecal mesenteric nodes were swollen. Resection of the terminal ileum, ileocecal region and ascending colon was performed. Histologic examinations of the obtained specimens revealed tuberculous change in the ileocecal region and mesenteric nodes. The nodules over the ileal mucosa were lymphoid hyperplasia. Pulmonary or other tuberculosis was not demonstrated. Antituberculous drugs were medicated for five months, and his postoperative course was satisfactory except for strangulated small bowel obstruction, which was made lysis without bowel resection. Although today primary tuberculous enteritis is rare, the possibility of this disease should be kept in mind in case that such a long-standing fistula as in this case developed after appendectomy.
1978-12-25