Miura Tomofumi, Shimizu Takao, Nakamura Junichiro, Yamada Satoshi, Yanagi Masahiko, Usuda Hiroyuki, Emura Iwao, Takahashi Toru
Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2010 Mar;107(3):416-26.
A 25-year-old woman was admitted with fever and right lower abdominal pain that had started 3 days after the administration of antituberculosis agents for pulmonary tuberculosis. She was given a diagnosis of intestinal tuberculosis with ileo-ileal fistula formation on computed tomography, colonoscopy and laboratory test findings. She was kept on anti-tuberculosis agents. Soon after, ileus and a micro abscess appeared near the fistula. Ileocecal resection with partial ileal resection resulted in a good postoperative clinical course. Tuberculosis is still a major infectious disease. Intestinal tuberculosis is very rarely associated with fistula formation, and when it occurs, is difficult to differentiate from Crohn disease. Our case strongly suggests that typical intestinal tuberculosis findings can help in differential diagnosis between intestinal tuberculosis and Crohn disease.