Intestinal Perforation as a Paradoxical Reaction to Antitubercular Therapy: A Case Report

Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a...

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Bibliographic Details
Published in:Annals of coloproctology 2021, 37(0), , pp.18-23
Main Authors: Kang, Sung Hoon, Moon, Hee Seok, Park, Jae Ho, Kim, Ju Seok, Kang, Sun Hyung, Lee, Eaum Seok, Kim, Seok Hyun, Lee, Byung Seok, Sung, Jae Kyu, Jeong, Hyun Yong, Lee, Kyung Ha
Format: Article
Language:English
Subjects:
antitubercular therapy
Case Report
extrapulmonary tuberculosis
intestinal perforation
paradoxical reaction
small intestine
일반외과학
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Summary:Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a paradoxical reaction to antitubercular therapy. A 55-year-old man visited the outpatient department with lower abdominal pain and weight loss. He was diagnosed with intestinal TB and started antitubercular therapy. After 3 months of antitubercular therapy, a colonoscopy revealed improvement of the disease. Three days after the colonoscopy, the patient visited the emergency room complaining of abdominal pain. Abdominal computed tomography revealed extraluminal air-filled spaces in the pelvic cavity. We diagnosed a small bowel perforation and performed an emergency laparotomy and a right hemicolectomy with small bowel resection. This report describes the case of intestinal perforation presenting as a paradoxical reaction to antitubercular and provides a brief literature review.
ISSN:2287-9714
2287-9722
DOI:10.3393/ac.2020.03.16.1