1. A Case Report of Ileocecal Tuberculosis

概要

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A 68-year-old man was admitted to the hospital because of epigastralgia after meal and right lower abdominal tumor. The tumor was firmly adherent to the abdominal wall and there was slight abdominal distension. On barium enema examination, a filling defect and stricture of ileocecal region were found, and the terminal ileum was dilatated. On fiberscopic examination, the tumor occupied the whole circumference of ileocecal wall and the endoscope could not be inserted beyond the stricture. Endoscopic diagnosis was carci-noma of the cecum, and biopsy was performed. Because of obstructive symptoms the patient was operated on at the 10th hospital day, before pathological diagnosis had been made.<BR>On operation the disseminated miliary tuberculi were found on the whole peritoneum and ileocecal resection was performed, followed by side-to-side anastomosis of stenosed ileum. Microscopic examination revealed classic tuberculous granuloma, and pathological diagnosis was ileocecal tuberculosis. The patient was discharged on 37th day after operation, followed by chemotherapy.<BR>Active pulmonary tuberculosis was not observed in this case.<BR>Although rare, hypertrophic intestinal tuberculosis occures almost 85% in the ileocecal region and it mimics carcinoma of the cecum.<BR>We reported a case of hypertrophic intestinal tuberculosis which had been very diffi-cult to differentiate from carcinoma of cecum.
日本大腸肛門病学会の論文