title: [Intestinal tuberculosis of the terminal ileum causing obstructive ileus and tuberculous peritonitis and presenting numerous peritoneal small red nodules: a case report].
abstract: A 38-year-old woman suffering from lower abdominal pain was referred to our hospital. Abdominal computed tomography showed marked thickening of the terminal ileum to the cecum, localized collection of ascites, and multiple mesenteric lymphadenopathy. A barium contrast small bowel series showed solitary severe stenosis of the terminal ileum with marked swelling of the ileocecal valve, where colonoscopy could not pass through, suggesting that ileal stenosis was caused by intestinal tuberculosis. She also showed strongly positive tuberculin skin test. Laparoscopy-assisted ileocecal resection was performed for confirmation of diagnosis and removal of the stenotic intestinal lesion. Laparoscopically, numerous small red nodules scattered on the stenotic ileal serosa, peritoneum, and mesenterium. Histopathological examination revealed ileal tuberculosis causing ulcerative stricture, and mesenteric tuberculous lymphadenitis. The small red nodules were formed of hemorrhagic tuberculous nodules.
authors.affiliation: Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshimura
authors.forename: Isuzu
authors.initials: I
authors.lastname: Ohwaki
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Akashi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Eikichi
authors.initials: E
authors.lastname: Ihara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ochiai
authors.forename: Makoto
authors.initials: M
authors.lastname: Tokumatsu
authors.forename: Teppei
authors.initials: T
authors.lastname: Kabemura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nakashima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007082:Ileum; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy; D008640:Mesenteric Lymphadenitis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D014385:Tuberculosis, Gastrointestinal / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D014388:Tuberculosis, Lymph Node / Q000209:etiology / Q000473:pathology / Q000601:surgery