Ileocaecal tuberculosis

Case contributed by Dr Ian Bickle

Presentation

Born in Indian subcontinent, TB prevalent country. Multiple overseas jobs. Previous ileocaecal surgery. New onset weight loss and anorexia.

Patient Data

Age: 49
Gender: Male
Fluoroscopy

Unusually high and atypical orientation of the ileocaecal junction ( post operative neo-terminal ileum).

Tight short segment stricture of the neo-terminal ileum with loop separation.  Non shouldered edges of the stricture.

CT

Thickening of the neo terminal ileum with marked surrounding inflammatory change.

Thick walled enhancing abscess in the right psoas/iliopsoas and right erector spinae muscles.

Small right retroperitoneal collection.

Case Discussion

The chief two diagnoses for ileocaecal pathology is Crohns disease and TB.

Both can cause similar appearances on CT.  A high level of suspicious is required in TB endemic regions.

Endoscopic and ideally histological or laboratory confirmation is desirable before the commencement of two very different types of treatment. 

PlayAdd to Share

Case information

rID: 41360
Case created: 28th Nov 2015
Last edited: 18th Jan 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.