Ileocecal tuberculosis misdiagnosed as appendicitis, and a fallacy of perception in lap chole

Posted by: mohindersingh98 on: January 8, 2007

In: operations
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7.1.2007

A fallacy of perception at lap chole occurred in a 35 years old talkative lady (relative of daughter-in-law of dr Modi). The long narrow neck of gallbladder was perceived as the cystic duct and thus the dissection remained at a higher level leading to confusions in anatomy, and the cystic artery not being found. A further lower dissection revealed the cystic duct at lower level, with the artery behind it in dense adhesions in the Calot’s triangle.

25 years old male from Jagraon was diagnosed as appendicitis and appendicectomy done at civil hospital Jagraon. Biopsy of appendix was reported as tuberculosis. Was started on antituberculous therapy. Had taken these drugs for 2 months, but continued to have attacks of intestinal obstruction.

At operation, the caecum was found to be contracted and and terminal ileum tightly strictured 2 strictures proximal to cecum along with other multiple strictures proximally. This 15 cm length of terminal ileum with strictures and cecum were excised and EEA done.