Presentation
Right iliac fossa pain.
Patient Data
Moderate segmental circumferential enhancing thickening of the wall of the cecum, ileocecal junction, and appendix (axial, coronal) with mucosal hyperenhancement, having maximum thickness ~ 16.0 mm in the cecum region. There are associated mild surrounding inflammatory changes. Few small sub-centimeter-sized discrete enhancing lymph nodes in the right iliac fossa region, the largest measuring ~ 7 mm in the short axis.
Inflammatory bowel disease (e.g. Crohn's disease) / Infective (e.g. Tubercular) may be considered. Colonoscopy and biopsy were suggested for further evaluation.
The histopathological report of the colonoscopy biopsy is suggestive of tuberculosis.
Case Discussion
Tuberculosis is one of the common causes of ileocecal wall thickening in India. However, the involvement of the appendix is an uncommon site for tuberculosis.
Co-author: Dr. Sanjoy Kumar (Director, Gastro-surgery).
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