Abstract
A 77-year-old woman was admitted to a local hospital for fracture of the femur. On the second hospital day, she complained of severe abdominal pain involving shock, and CT revealed free air in the abdominal cavity. She was transferred our hospital and we conducted emergency surgery ; she was diagnosed with peritonitis due to digestive tract perforation. The operative findings showed a perforation of the ileum which was located anal side 200cm from the ligament of Treitz, with 2 circular ulcers located on the anal side of the perforation site. Partial resection of the small intestine was performed. The histopathological findings of the resected specimen revealed inflammatory cell infiltration of the fullthickness of the intestinal wall and epithelioid granulomas containing Langhans' giant cells with caseous necrosis. Based on these findings, we diagnosed the patient with intestinal tuberculosis. As Mycobacterium tuberculosis infections have increased in recent years, we should consider intestinal tuberculosis as a cause of intestinal perforation.
