Spontaneous Tubercular Enterocutaneous Fistula

Saudi Journal of Medicine & Medical Sciences
Mudassar Shah, Munir A Wani

Abstract

Spontaneous enterocutaneous fistula can occur in patients with Crohn's disease, malignancy, typhoid or radiation exposure. Tuberculosis is a rare cause of enterocutaneous fistula. A 60-year-old female with no significant previous history presented with a feculent discharge from a fistulous opening on the right gluteal region for 3 months. There was also a history of extrusion of multiple Ascaris worms through the opening. Abdominal ultrasonography showed no intraperitoneal fluid collections. A contrast-enhanced computed tomography of the abdomen, magnetic resonance (MR) imaging and MR fistulogram revealed cortical destruction of the right iliac bone with fluid coursing along a tract, from the small gut loops attached to bone internally through the iliac bone to the soft tissues in the right gluteal region before opening on the skin. A biopsy from the tissue of the fistula site revealed tuberculosis. The patient responded well to conservative management and was discharged after 4 weeks.

Citations

Dec 29, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Caroline CouperEzra Steiger

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