PMC5848136_01
CT demonstrating concentric bowel wall thickening in the region of the splenic flexure (blue arrow) with sparing of the region of the hepatic flexure (yellow arrow). The patient later developed colonic obstruction at both sites.
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Soon after antituberculin therapy was initiated she developed a large bowel obstruction with segmental colitis and strictures at multiple areas including the splenic and hepatic flexures as seen on CT scan (Figures 1 and 2), and she required a subtotal colectomy with end-ileostomy.
CT demonstrating distal luminal narrowing of bowel loops at both the splenic flexure (red arrow) and hepatic flexure (yellow arrow) with associated bowel wall thickening and edema.
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Soon after antituberculin therapy was initiated she developed a large bowel obstruction with segmental colitis and strictures at multiple areas including the splenic and hepatic flexures as seen on CT scan (Figures 1 and 2), and she required a subtotal colectomy with end-ileostomy.
Colonoscopy image showing circumferential friable ulcerated mucosa in the descending colon.
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Colonoscopy showed circumferential friable ulcerated mucosa in the descending colon (Figure 3).
Histopathology of full thickness section of colon with pericolonic fat showing confluent necrotizing granulomatous inflammation involving transmural colonic wall.
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Pathology of the resected colon showed confluent necrotizing granulomatous inflammation with transmural colonic wall involvement and stricture at the splenic flexure, as well as necrotizing granulomas of the surrounding lymph nodes, consistent with tuberculosis (Figures 4 and 5).
2 lymph nodes with confluent necrotizing granulomatous inflammation as visualized at 1x (inset) and 20x.
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Pathology of the resected colon showed confluent necrotizing granulomatous inflammation with transmural colonic wall involvement and stricture at the splenic flexure, as well as necrotizing granulomas of the surrounding lymph nodes, consistent with tuberculosis (Figures 4 and 5).