Intestinal tuberculosis mimicking Crohn’s disease with ascending colon sinus tract: a case report

Background: Intestinal tuberculosis (ITB) complicated by sinus tract is clinically characterized by nonspecific symptoms. This condition necessitates multidisciplinary collaboration, and a multidimensional differential diagnostic approach integrating clinical manifestations, imaging findings, and pathological examination is imperative for confirmation. Case summary: A 26-year-old female presented with a 1-month history of recurrent right lower abdominal pain. She had previously been misdiagnosed with appendicitis and Crohn's disease (CD). Through a comprehensive diagnostic workup including small intestine computed tomography enterography (CTE), purified protein derivative (PPD) test, colonoscopy, and pathological assessment, the patient was diagnosed with ITB complicated by a sinus tract of the ascending colon. Quadruple anti-tuberculosis therapy was initiated. Notably, the fistula achieved complete closure 6 months post-treatment. Conclusion: This case highlights the critical importance of multidisciplinary diagnosis and treatment in managing ITB. It provides valuable reference material for the clinical diagnosis of such rare complications, thereby contributing to improved clinical decision-making in similar cases.