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Appendicular tuberculosis presenting as enterocutaneous fistula over thigh—A rare case report with review of literature.doc

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Appendicular tuberculosis presenting as enterocutaneous fistula over thigh—A rare case report with review of literature

Vol.1, No.3, 37-39 (2013) Journal of Tuberculosis Research /10.4236/jtr.2013.13007 Appendicular tuberculosis presenting as enterocutaneous fistula over thigh—A rare case report with review of literature Vaibhav Pandey , Ajay Narayan Gangopadhyay, Shiv Prasad Sharma, Vijayndar Kumar * Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India; Corresponding Author: sunny.imsbhu@ * Received 23 July 2013; revised 11 September 2013; accepted 24 September 2013 Copyright ? 2013 Vaibhav Pandey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT done outside, following which she developed fecal dis- charge from the incision site (Figure 1). Patient had also mild pain in right iliac fossa. On examination there was guarding and mild tenderness in the right iliac fossa. Ul- trasonogram of abdomen showed localized collection in the right iliac fossa. Barium meal follows through show- ed spillage of dye from Ileocaecal region and presence of fistulous tract towards right thigh. Exploratory laparo- tomy was performed, intraoperatively appendix was in- flammed and there was a perforation over the tip of ap- pendix (Figure 2) with purulent fluid in the right iliac fossa. Terminal ileum, rest of the bowel, peritoneum and other abdominal organs were normal. On further explo- ration, fistulous tract was found in the iliac fossa going to the front of thigh. Appendectomy followed by curettage of the tract with minimal debridement of the edge was done. Appendectomy specimen and the biopsy from the edge of the tract were sent for histopathological exami- nation. Histological picture of the appendix showed fea- tures of tuberculosis. Investigations for pulmonary and extrapulmonary tuberculosis were ne