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Open Access Case report

Primary tubercular caecal perforation: a rare clinical entity

Devendra K Jain, Gaurav Aggarwal*, Parvinder S Lubana, Sonia Moses and Nitin Joshi

Author Affiliations

Department of Surgery, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh -452001, India

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BMC Surgery 2010, 10:12  doi:10.1186/1471-2482-10-12

Published: 31 March 2010

Abstract

Background

Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon.

Case presentation

We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum.

Conclusions

We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.