Recurrent attacks of Ileocaecal Tuberculosis: WHAT TO DO?
A 45 Years old patient came to our hospital second time with the chief complaint of severe abdominal pain since 2 years, sudden in onset, moderate to severe in intensity, associated with nausea and vomiting, with H/o constipation present. Patient is having multiple times similar episodes. Colonoscopy guided biopsy was inconclusive, but Ct findings suggests Abdominal Tuberculosis, so ATT was started 4 months back and since then patient id on ATT. There is no H/o hypertension. Diabetes mellitus. The systemic examination is WNL. Local examination reveals Soft distended abdomen, mild tenderness present, mass in right iliac region which moves with respiration.
Laboratory investigations and Radiological Investigations in the file attached.
what should be done?
Patient was treated with surgery: Ileocolic Resection under General Anaesthesia.
1. multiple enlarged ileal mesenteric lymph nodes.
2. mass in terminal ileum about 6.0 cm proximal to IC junction causing obstruction.
3. Enlarged matted lymph nodes adjacent to mass, causing obstruction to medial wall of caecum
4. Oedematous dilated proximal ileum.