A CASE OF SIGMOID COLON STRICTURE - TUBERCULOSIS THE GREAT MIMIC

BACK GROUND - Segmental colonic tuberculosis being a rarity in sigmoid colon withlimited no of cases reported so far. CASE REPORT - A 68 yrs old male presented with lowerabdominal pain of 1 month duration, associated with dysuria and difficulty in micturition. There washistory of loss of appetite, weight with constipation present on and off. Investigation revealed astricture involving long segment of sigmoid colon and adherent to posterior wall of the bladder on theleft side. Possibility of malignant or inflammatory etiology. Cystoscopy guided biopsy of bladder lesionshowed granulomatous lesion. Diagnostic laparoscopy done and proceeded with Laparotomyresection of stricture segment of sigmoid colon and primary colocolic anastomosis. Histopathologyreport confirmed tuberculous colitis. Patient was started on anti tuberculous (ATT) medication. Patientis on regular follow up. CONCLUSION - Tuberculosis is known to involve any segment of gastrointestinal tract. While tuberculosis of the small bowel is common, isolated primary tuberculosisof the large bowel is quite uncommon. Tuberculosis of colon forms only 3 to 4 of intestinaltuberculosis. Tuberculosis of the colon tends to be segmental and usually obstructive symptomsdominate. However the diagnostic challenge is very high when isolated colonic segments areinvolved with tuberculosis.