Barbagallo F, Latteri S, Sofia M, Ricotta A, Castello G, Chisari A, Randazzo V, Greca GL. Appendicular tuberculosis: The resurgence of an old disease with difficult diagnosis. World J Gastroenterol 2010; 16(4): 518-521 [PMID: 20101782 DOI: 10.3748/wjg.v16.i4.518]
Corresponding Author of This Article
Francesco Barbagallo, MD, Department of Surgical Sciences, Transplantation and New Technologies, University of Catania, Via Messina 354, 95126 Catania, Italy. barbaf74@tiscali.it
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 28, 2010; 16(4): 518-521 Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.518
Appendicular tuberculosis: The resurgence of an old disease with difficult diagnosis
Francesco Barbagallo, Saverio Latteri, Maria Sofia, Agostino Ricotta, Giorgio Castello, Andrea Chisari, Valentina Randazzo, Gaetano La Greca
Francesco Barbagallo, Saverio Latteri, Maria Sofia, Agostino Ricotta, Giorgio Castello, Andrea Chisari, Valentina Randazzo, Gaetano La Greca, Department of Surgical Sciences, Transplantation and New Technologies, University of Catania, Via Messina 354, 95126 Catania, Italy
Author contributions: Barbagallo F and La Greca G contributed equally to this work; Barbagallo F, La Greca G and Latteri S designed the research; Barbagallo F, La Greca G, Latteri S, Ricotta A and Castello G performed the research; Chisari A acquired and elaborated the images; Barbagallo F and La Greca G, Randazzo V and Sofia M analyzed the data; Barbagallo F and La Greca G wrote the paper.
Correspondence to: Francesco Barbagallo, MD, Department of Surgical Sciences, Transplantation and New Technologies, University of Catania, Via Messina 354, 95126 Catania, Italy. barbaf74@tiscali.it
Telephone: +39-347-3095821 Fax: +39-95-7122221
Received: March 14, 2009 Revised: December 4, 2009 Accepted: December 11, 2009 Published online: January 28, 2010
Abstract
Gastrointestinal tuberculosis (TB) is quite rare, representing only 3% of all extra-pulmonary cases. Blind gut and ileum are the most common gastrointestinal localizations, while appendix involvement is infrequent. Appendix involvement is usually related to symptoms of acute appendicitis since the caseous necrosis may lead to adhesions and surgical complications such as perforation. For this reason patients with suspected appendicular TB usually undergo surgery even without a secure diagnosis. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed after surgery, thus resulting in a high percentage of important, and sometimes lethal, complications. Histopathological examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy, while an early diagnosis could avoid surgical treatment. We report a case of appendicular TB not only for its rarity but also to discuss the difficulty in its diagnosis.
