CASE REPORT- AN INTERESTING CASE OF ACUTE STRICTURISING CROHNS MIMICKING TB

Abstract

Intestinal Tuberculosis is the closest mimic of Cohns Disease and Diagnostic
dilemmas persist in differentiating, the two chronic granulomatous disorders. We present a case of 21
year old Female who presented with acute abdomen. Clinically and imaging wise features mimicked
acute appendicitis. An emergency surgery was done intra operative findings were suggestive of
tuberculous peritonitis with dense adhesions around appendicular and ileocaecal region. She
developed acute intestinal obstruction, hypotension and shock in the immediate post-operative
period, for which she was taken up for a second major surgery peritoneal lavage and end ileostomy.
The initial HPE reports came as Tuberculous granuloma. Symptoms persisted even after 3 months of
ATT. Subsequent investigations revealed multiple large intestinal strictures which necessitated Total
colectomy with Ileosigmoid anastomosis. It took an ordeal to establish Crohns Disease in this patient
and the time delay had resulted in multiple sessions of surgery and extensive strictures and finally
ended in total colectomy.