ABSTRACT
Abdominal tuberculosis (ATB) constitutes 12% of the extra pulmonary disease and is a rare but well-documented cause of perforation peritonitis, occasionally occurring in cases where the diagnosis has been delayed but may occur even after antituberculous therapy has been initiated. Most patients with tuberculosis strictures respond well to medical treatment and should be resorted to surgery only if drug therapy fails. Despite surgical intervention, tuberculosis perforation has a high complication and mortality rate. We present a case of 54-year-old male patient with a perforated jejunal stricture who had completed his treatment for pulmonary tuberculosis one month earlier. This case was unusual because of the age of patient at presentation (usually seen in young - 25 to 45 y), involvement of jejunum (commonly ileocaecal region), initial presentation with subacute obstruction followed by peritonitis (refused treatment at first instance) and patient having completed treatment for pulmonary tuberculosis recently.
ABSTRACT
Actinomyces are part of normal oral flora and cause disease only when the normal mucosal barrier is breached. Reported annual incidence of actinomycosis is 1 case per 300,000 persons (Weese and Smith, Arch Intern Med 135:1562-1568, 1975). Preoperative diagnosis of abdominal actinomycosis is difficult. An accurate diagnosis is always obtained by histological examination and often requires surgical resection. This case of mesenteric panniculitis due to fish bone penetrating the gut wall and lodging in the omentum has been taken for its rare presentation.
