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Solitary Jejunal Tuberculosis with Intestinal Obstruction in an Immunocompetent Patient

면역 능력이 있는 성인에서의 장폐색을 동반한 단일 공장 결핵 1예

  • Bae, Hyun Jin (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Jong Ho (Division of Gastroenterology, Department of Internal Medicine, Changwon Fatima Hospital) ;
  • Jin, Su Sin (Division of Gastroenterology, Department of Internal Medicine, Changwon Fatima Hospital) ;
  • Jung, Jiyun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Nam, Yun Jung (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Da Won (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 배현진 (가톨릭대학교 의과대학 내과학교실) ;
  • 박종호 (창원파티마병원 소화기내과) ;
  • 진수신 (창원파티마병원 소화기내과) ;
  • 정지윤 (가톨릭대학교 의과대학 내과학교실) ;
  • 남윤정 (가톨릭대학교 의과대학 내과학교실) ;
  • 김다원 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2016.07.17
  • Accepted : 2017.08.02
  • Published : 2018.12.01

Abstract

Intestinal tuberculosis is an infection of the gastrointestinal tract by the Mycobacterium tuberculosis complex. To the best of our knowledge, solitary intestinal tuberculosis accompanied by intestinal obstruction, particularly in the middle of the small intestine, is extremely rare. We report a case of solitary jejunal tuberculosis in a 49-year-old man with no underlying disease. He was admitted a few days after the onset of diffuse abdominal discomfort. Upon evaluation, we initially considered a malignancy of the distal jejunum with ileus due to the presence of a mass. Therefore, he underwent laparoscopic resection of the small bowel. Unexpectedly, the histologic specimen showed a chronic caseating granulomatous lesion with acid-fast bacilli. Ultimately, he was diagnosed with solitary jejunal tuberculosis. He was successfully treated with anti-tuberculosis drugs without any complications.

Keywords

References

  1. Akcakaya A, Sahin M, Coskun A, Demiray S. Comparison of mechanical bowel obstruction cases of intra-abdominal tumor and non-tumoral origin. World J Surg 2006;30:1295-1299. https://doi.org/10.1007/s00268-005-0440-z
  2. Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep 2003;5:273-278. https://doi.org/10.1007/s11894-003-0063-1
  3. World Health Organization. Global tuberculosis report 2015. Geneva: World Health Organization, 2015.
  4. Korea Centers for Disease Control and Prevention. Korea centers for disease control and prevention annual report on the notified tuberculosis in Korea [Internet]. Osong (KR): Korea Centers for Disease Control and Prevention, c2015 [cited 2016 Jul 17]. Available from: http://www.cdc.go.kr/CDC/info/CdcKrInfo0302.jsp?menuIds=HOME001-MNU1132-MNU1138-MNU0038&cid=67545.
  5. Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis (Seoul) 2015;78:47-55. https://doi.org/10.4046/trd.2015.78.2.47
  6. Horvath KD, Whelan RL. Intestinal tuberculosis: return of an old disease. Am J Gastroenterol 1998;93:692-696. https://doi.org/10.1111/j.1572-0241.1998.207_a.x
  7. Choy MC, Christensen B, Desmond PV. Ileocaecal tuberculosis: re-emergence in developed countries. Intern Med J 2013;43:342-345. https://doi.org/10.1111/imj.12056
  8. Park SH, Yang SK, Yang DH, et al. Prospective randomized trial of six-month versus nine-month therapy for intestinal tuberculosis. Antimicrob Agents Chemother 2009;53:4167-4171. https://doi.org/10.1128/AAC.00874-09
  9. Son HJ, Kim JJ, Lee PR, et al. A case of small bowel tuberculosis which was misdiagnosed as small bowel cancer. In: Gastroenterol KJ, ed. The 34th Korean Journal of Gastroenterology fall research conference proceedings; 1995 Jan 1; Seoul (KR): Korean J Gastroenterol, 1995:135-135.
  10. Chung JS, Cho YB, Heo WG, Jo DH, Jeong YH, Seo GS. Asymptomatic synchronous tuberculosis involving stomach and small bowel in immunocompetent patient. Korean J Gastroenterol 2015;66:345-349. https://doi.org/10.4166/kjg.2015.66.6.345