J Korean Surg Soc.  2012 Apr;82(4):266-269. 10.4174/jkss.2012.82.4.266.

Primary tuberculosis appendicitis with mesenteric mass

• Nam SH
• Kim JS
• Kim KH
• Park SJ

• KMID: 1820077
• DOI: http://doi.org/10.4174/jkss.2012.82.4.266

Abstract

Tuberculosis primarily affecting the appendix is extremely rare and the diagnosis is difficult. Here, we report the case of a 14-year-old healthy boy presenting with right lower quadrant abdominal pain. On computed tomography, the distended appendix with 3.3 x 2.7 cm mass located at the right side of the right iliac artery was detected. There was neither bowel wall thickening nor active lung lesion. After laparoscopic appendectomy with mass excision, histopathological examination revealed chronic granulomatous inflammation, with caseous necrosis of the appendix. We made a diagnosis of primary tuberculosis of appendix and administrated anti-tuberculosis medication.

Keyword

Tuberculosis; Appendicitis; Mesenteric lymphadenitis

MeSH Terms

Abdominal Pain
Adolescent
Appendectomy
Appendicitis
Appendix
Humans
Iliac Artery
Inflammation
Lung
Mesenteric Lymphadenitis
Necrosis
Tuberculosis

Figure

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  Fig. 1 Computed tomography shows distended appendix (12 mm), with cystic change at the tip (arrow).

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  Fig. 2 Computed tomography shows the 3.3 by 2.7 cm sized mass located next to the right iliac vessel. It accompanies small calcification with necrotic change (arrow).

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  Fig. 3 The appendix was diffusely enlarged and distended, and it showed suppurative change.

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  Fig. 4 Histopathologic findings revealed chronic granulomatous inflammation, with caseous necrosis (H&E, ×400).

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