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CASE REPORT
Year : 2017  |  Volume : 5  |  Issue : 3  |  Page : 275-277

Spontaneous tubercular enterocutaneous fistula


Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Mudassar Shah
Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar - 190 011, Jammu and Kashmir
India
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DOI: 10.4103/1658-631X.213301

PMID: 30787802

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Spontaneous enterocutaneous fistula can occur in patients with Crohn's disease, malignancy, typhoid or radiation exposure. Tuberculosis is a rare cause of enterocutaneous fistula. A 60-year-old female with no significant previous history presented with a feculent discharge from a fistulous opening on the right gluteal region for 3 months. There was also a history of extrusion of multiple Ascaris worms through the opening. Abdominal ultrasonography showed no intraperitoneal fluid collections. A contrast-enhanced computed tomography of the abdomen, magnetic resonance (MR) imaging and MR fistulogram revealed cortical destruction of the right iliac bone with fluid coursing along a tract, from the small gut loops attached to bone internally through the iliac bone to the soft tissues in the right gluteal region before opening on the skin. A biopsy from the tissue of the fistula site revealed tuberculosis. The patient responded well to conservative management and was discharged after 4 weeks.


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