Ileocaecal tuberculosis

Case contributed by Dr Ian Bickle


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

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.


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. 

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Case information

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

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