Ileal Stenoses with Diverticuli in a Patient with Pulmonary Tuberculosis, Report of a Case Tetsushi Ishida 1 , Seiji Shimizu 2 , Eiwa Ishida 3 , Chihiro Yokomizo 2 , Wataru Fukuda 2 , Koichi Uejima 2 , Hidetaka Takashima 2 , Hideo Tomioka 2 , Takehisa Matsuyama 4 , Shiro Ogino 5 , Toshikazu Akami 5 , Shinji Okano 5 , Yutaro Egashira 6 , Shingo Ishiguro 7 1Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan 2Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan 3Division of Pathology, Nara Prefecture General Medical Center, Nara, Japan 4Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan 5Division of Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan 6Department of Pathology, Osaka Medical College, Takatsuki, Japan 7PCL Osaka Pathology & Cytology Center, Ibaraki, Japan Keyword: 回腸憩室 , 回腸潰瘍 , 回腸狭窄 , 肺結核 , 腸結核 pp.1727-1733
Published Date 2016/12/25
DOI https://doi.org/10.11477/mf.1403200798
  • Abstract
  • Look Inside
  • Reference

 A 68-year-old man, who had been treated for atypical mycobacterial infection following termination of treatment for pulmonary tuberculosis, presented with small intestinal ileus. Radiographic and endoscopic examinations revealed multiple diverticuli, ulcers, and stenoses in the ileum, located within 70cm of the ileocecal valve. Surgery was performed because of severe stenoses. The resected specimen showed multiple pseudodiverticuli that were exclusively lined on the mesenteric border Irregularly shaped ulcers were found to be distributed around and between the diverticuli. Ulcers were approximately UL-II in depth and were accompanied by edema and dense submucosal fibrosis. Stenoses were considered to be caused by wall thickening due to submucosal fibrosis and hypertrophy of the proper muscle layer. The presence of small, noncaseating epithelioid granulomas in the lymph nodes was suggestive of healed intestinal tuberculosis. However, the macroscopic appearances of ileal lesions were different from those of intestinal tuberculosis. Instead, ileal diverticuli may have been related to the formation of ulcers and stenoses in this patient.

Copyright © 2016, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院