Abdominal Tuberculosis Presenting as Acquired Megacolon

Background: Tuberculosis is a chronic granulomatous infection caused by the bacilli Mycobacterium tuberculosis. Decades after the discovery of effective treatment, the infection persists till date as a re-emerging communicable disease. It is preventable by childhood vaccination. Its presentation may be protean and mimic many other conditions. Abdominal tuberculosis presents a diagnostic challenge hence the need to expose the various shades of presentation to aid prompt diagnosis and proper management to reduce attributable morbidity and mortality. We report a case of abdominal tuberculosis presenting as acquired Megacolon

Case Report: A 28-year-old mother of three presented with six months history of recurrent constipation, marked weight loss, gross abdominal distension and colicky abdominal pain. She was evaluated and a clinical impression of acquired Megacolon was made but at laparotomy features of abdominal tuberculosis were found and confirmed by histopathologic examination of biopsied granulomatous lesions on the colon and lymph nodes. A temporary loop colostomy was fashioned and later closed after six-month successful treatment with antituberculosis drugs.

Conclusion: Abdominal tuberculosis should be considered in the differential diagnosis of adult patients presenting with chronic constipation and distension.