Primary tubercular caecal perforation: a rare clinical entity

<p>Abstract</p> <p>Background</p> <p>Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon.</p> <p>Case presentation</p> <p>We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix. A standard right hemicolectomy with ileostomy and peritoneal toileting was done. Histopathology revealed multiple transmural caseating granulomas with Langerhans-type giant cells and acid-fast bacilli, consistent with tuberculosis, present only in the caecum.</p> <p>Conclusions</p> <p>We report this extremely rare presentation of primary caecal tuberculosis to sensitize the medical fraternity to its rare occurrence, which will be of paramount importance owing to the increasing incidence of tuberculosis all over the world, especially among the developing countries.</p

Lymphomes et pseudolymphomes gastriques. [Gastric lymphomas and pseudolymphomas]

We report 30 cases of non-Hodgkin's gastric lymphomas (according to the Rappaport classification): 1 nodular lymphocytic lymphoma well differentiated, 7 diffuse lymphocytic lymphomas poorly differentiated, 2 diffuse mixed cellularity lymphomas, 20 diffuse histiocytic lymphomas and 4 pseudolymphomas, over a period of 21 years at the CHUV, in Lausanne (1958-1979). There are 56% of advanced stages (IIIE and IVE) according to Ann Arbor. Survival to 5 years is of 27%. The mean survival of patients who died from their lymphomas is of 5 months only. Lymph node invasion worsens considerably the prognosis (75% of survival to 5 years for stage IE against 25% for stage IIE). This phenomenon is particular to non-ganglionary lymphomas. We do not observe good remission for the diffuse histiocytic forms at an advanced stage, remission being characteristic of the ganglionary lymphomas only. Treatment is poorly codified. Surgery along seems possible for the localised forms (IE): triple therapy (surgery, radiotherapy and chemotherapy) is necessary for advanced stages and histological unfavorable forms