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Ileocecal tuberculosis with intestinal obstruction

Case contributed by Paresh K Desai
Diagnosis almost certain

Presentation

Appendectomy 1 week prior. Now presents to the emergency department with acute right illiac fossa pain and abdominal distension. Patient was scanned within 1 hr of the arrival.

Patient Data

Age: 35 years
Gender: Female

Contrast CT of the abdomen

ct

Terminal ileal stricture with thickening. 

Cecum is deformed with thickening of its walls.

Multiple mesenteric lymph nodes in right illiac fossa.

Small bowel obstruction.

No pneumoperitoneum

Reactionary free intraperitoneal fluid.

Case Discussion

Imaging features raise a possibility of ileocecal tuberculosis.

Patient was treated conservatively

Ileocecal tuberculosis confirmed later on biopsy.

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