Spontaneous tubercular enterocutaneous fistula developing in the scar of a surgery done 14 years earlier

ABSTRACT

We report a case of spontaneous tubercular enterocutaneous fistula, which occurred after a long interval of 14 years after an appendicectomy. A 32-year-old male presented with the complaint of fecal matter coming out continuously from an opening present over the scar of previous surgery. The only significant past history was that of appendicectomy done 14 years back for acute appendicitis [nontubercular]. Histopathology of tissue taken from the margins of the fistulous opening showed caseating granuloma, consistent with tuberculosis. Treatment was provided successfully in the form of fistulectomy and right hemicolectomy with ileotransverse anastomosis along with a 9-month course of four-drug antitubercular treatment. Regular follow-up for the last 2 years has been uneventful