Multi-Detector CT Findings of Primary Tubercular Appendicitis: A Case Report

Multi-Detector Computed Tomography (MDCT) increases the accuracy of diagnosis for cases of acute appendicitis (1, 2). The imaging findings of acute appendicitis are well documented which include a dilated nonopacified appendix, fat stranding, and an appendicolith (1). Acute appendicitis arises from an appendicolith or obstruction of the appendix. The appendix is also involved in intestinal inflammatory diseases such as Crohn’s disease and intestinal tuberculosis (3, 4). However, primary tuberculosis of the appendix is extremely rare. Although tuberculosis of the appendix can occur, its incidence is rare, occurring in only about 1.5 to 3.0% of the patients who have intestinal tuberculosis (4). The appendix may either be involved secondarily to ileocecal tuberculosis or may occur in the even rarer “isolated” form without evidence of the disease elsewhere (4). A literature review revealed imaging findings of tubercular appendicitis (primary tubercular appendicitis or secondary tubercular appendicitis) (5, 6). The authors experienced primary tuberculosis of the appendix with MDCT imaging findings. However, to the best of our knowledge, the MDCT findings of a case of primary tubercular appendicitis has not been previously described. We present here the MDCT findings of primary tubercular appendicitis.