Vázquez RJA, Vázquez GA, Vázquez GAL, López J, Ramírez BÉJ

Language: Spanish
References: 11
Page: 113-115
PDF size: 91.35 Kb.

ABSTRACT

Objective: To present a case of appendicular tuberculosis as cause of acute abdomen and to review the literature covering aspects of appendicitis and appendicular tuberculosis. To arise the interest of the reader on the rare etiology of a common alteration such as the acute abdomen.
Setting: Hospital Central Universitario, Universidad Autónoma de Chihuahua. Chihuahua, Chihuahua, Mexico.
Design: Case report.
Summary: Male patient, 28-year-old, peasant, analphabet. Tarahumara Indian, with sub-optimal hygiene and feeding habits, coursing with pulmonary and pharyngeal tuberculosis of 18-month evolution without control. He seeks medical care due to intense abdominal pain for the last two days. Physical exploration revealed general malady, dehydration, alert, arterial pressure of 110/70 mmHg, cardiac frequency of 98, respiratory frequency of 28, body temperature of 38°C. Bilateral crepitating stertors and bi-basal hypoventilation. Rigid painful abdomen. An exploratory laparotomy was indicated, finding 1,000 ml of purulent material, fibropurulent scum, edema of intestinal loops, and acute appendicitis of the cecum. The anatomopathological study reported chronic granulomatous appendicitis of timic origin. On day 16 of hospitalization, the patient presented an unfavorable evolution, with acute abdomen, fecal matter fistula due to dehiscence of the appendicular stump and the ascending colon. The patient continued to get worse, developing septic shock and multiorgan failure; he died on day 26 after admission.
Conclusion: Tuberculosis has become an emerging disease worldwide due to the lack of control of infectious patients and lack of treatment adherence, constituting the sine qua non for the occurrence of the different forms of tuberculosis, as is the case of appendicular tuberculosis.

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