Abstract
A 59-year-old man was admitted to our hospital with complaints of fever and suspected lung tuberculosis. He was diagnosed as having ileus three weeks after taking antituberculosis drugs. A barium enema and colonoscopy revealed stenosis of the cecum, inflammatory polyps and circular ulcers. A biopsy revealed Crohn's disease. Surgical findings showed a cecal mass and a little over 40 constrictions in the small intestine with wall thickening. It is rare to find an ileum with penetration into the rectum. The penetrating ulcer measured 3×3cm. Macroscopic examination of the resected specimen showed that there were several girdle ulcers in the cecum and many round to oval ulcers in the small intestine. All ulcers of the intestine were on the side opposite the mesentery. Histologically, there were multiple non-caseous granulomas throughout the resected intestine, but a few caseous granulomas were surrounded by Langhans' giant cells. Fibrous thickening of the submucosa in the ulcer regions was absent. Therefore this case was diagnosed as intestinal tuberculosis.
