title: Appendicular tuberculosis: review of 155 published cases and a report of two cases.
abstract: OBJECTIVE
  This paper provides an overview of the literature on appendicular tuberculosis (ATB) between 1909 and 2010.
  
  
  METHODS
  We present two cases of primary ATB and a literature review of studies on ATB published in English and accessed via the Pubmed and Google Scholar databases.
  
  
  RESULTS
  One hundred fifty-five published cases of ATB were reviewed, and two patients with primary ATB, treated and followed in our clinic, were reported. The age range of the patients (62 females, 60 males and 33 with unnoted gender) was between 2 and 60 years, with a mean age of 27.1 ± 10.6 years. Of the patients who had applied to hospital, 59 had acute right lower quadrant pain, 46 had recurrent right lower quadrant pain, 19 had generalized pain, and 10 had chronic abdominal symptoms suggestive of subacute intestinal obstruction, while 47 patients were operated on with a diagnosis of acute appendicitis, 24 with recurrent appendicitis, 19 with TB peritonitis, 14 with mass in the right lower quadrant, 13 with subacute intestinal obstruction, and 7 with ATB. While appendectomy was not performed on 4 patients, one or more of the following procedures were done in the other 151 cases: appendectomy, hemicolectomy, ileocecal resection, or cecectomy. Different anti-tubercular treatment regimens with durations varying from 3 weeks to 18 months were applied to 60 patients. During the follow-up period of 3 weeks to 15 years, mortality occurred in 14 patients, sinus in five, and fistula in one patient. Secondary ATB was detected in 86 patients, primary ATB in 50, and no differential diagnosis could be made in 19 cases.
  
  
  CONCLUSIONS
  Tuberculosis is a systemic disease with localized manifestations; therefore, anti-TB therapy must be initiated in any patient whose pathologic specimen reveals tuberculosis.
authors.affiliation: Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey. akbulutsami@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Akbulut
authors.affiliation: Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Yagmur
authors.affiliation: Department of Pathology, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Bakir
authors.affiliation: Department of Pathology, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Sogutcu
authors.affiliation: Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Yilmaz
authors.affiliation: Department of Radiology, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Senol
authors.affiliation: Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, 21400, Turkey.
authors.forename: M V
authors.initials: MV
authors.lastname: Bahadir
keywords: Appendicular tuberculosis; Extrapulmonary tuberculosis; Tuberculosis; Tuberculous appendicitis; Tuberculous peritonitis
references.citation: Ann Surg. 1920 Feb;71(2):139-48
references.pmid: 17864232
references.citation: Postgrad Med J. 1987 Oct;63(744):855-7
references.pmid: 3447110
references.citation: World J Emerg Surg. 2006 Jul 26;1:22
references.pmid: 16872481
references.citation: Pediatr Int. 2004 Jun;46(3):374-6
references.pmid: 15151563
references.citation: J Ayub Med Coll Abbottabad. 2005 Apr-Jun;17(2):88-9
references.pmid: 16092662
references.citation: East Mediterr Health J. 2008 May-Jun;14(3):742-4
references.pmid: 18720639
references.citation: Cal West Med. 1939 Mar;50(3):176-9
references.pmid: 18745059
references.citation: Ann Surg. 1917 Dec;66(6):648-53
references.pmid: 17863824
references.citation: Am Surg. 1975 Mar;41(3):172-4
references.pmid: 1119758
references.citation: Int Surg. 1977 Oct;62(10):563-4
references.pmid: 591227
references.citation: Clin Infect Dis. 1994 Apr;18(4):650-1
references.pmid: 8038328
references.citation: World J Gastroenterol. 2010 Jan 28;16(4):518-21
references.pmid: 20101782
references.citation: Turk J Gastroenterol. 2010 Mar;21(1):1-2
references.pmid: 20533103
references.citation: Gastroenterol Clin Biol. 2005 Apr;29(4):419-24
references.pmid: 15864206
references.citation: J Ayub Med Coll Abbottabad. 2006 Oct-Dec;18(4):42-6
references.pmid: 17591009
references.citation: Med J Aust. 1955 May 21;42(1 21):756-9
references.pmid: 14393176
references.citation: Postgrad Med J. 1993 May;69(811):411-2
references.pmid: 8346145
references.citation: ANZ J Surg. 2009 Sep;79(9):662
references.pmid: 19895534
references.citation: Am J Surg. 1956 Mar;91(3):389-93
references.pmid: 13292629
references.citation: Arch Gynecol Obstet. 2010 Dec;282(6):639-42
references.pmid: 20091044
references.citation: Am J Trop Med Hyg. 2010 Mar;82(3):512-5
references.pmid: 20207884
references.citation: Br Med J. 1936 Dec 26;2(3964):1305-6
references.pmid: 20780373
references.citation: N Engl J Med. 1952 Feb 28;246(9):329-31
references.pmid: 14899638
references.citation: Indian J Pediatr. 2005 Aug;72(8):712
references.pmid: 16131783
references.citation: Trop Doct. 2004 Jan;34(1):36-8
references.pmid: 14959975
references.citation: Indian J Gastroenterol. 1987 Oct;6(4):247
references.pmid: 3679315
references.citation: Can Med Assoc J. 1954 Aug;71(2):159-60
references.pmid: 13182656
references.citation: Br J Clin Pract. 1990 Dec;44(12):632-3
references.pmid: 2102163