True about hyperplastic type of tuberculosis
Ulcerative type: When a patient with pulmonary tuberculosis swallows infected sputum, the organism colonises the lymphatics of the terminal ileum, causing transverse ulcers with typical undermined edges. The serosa is usually studded with tubercles. Denotes a severe form of the disease in which the virulence of the organism overwhelms host resistance.Hyperplastic type: This occurs when host resistance has the upper hand over the virulence of the organism. It is caused by drinking infected unpasteurised milk. There is a marked inflammatory reaction causing hyperplasia and thickening of the terminal ileum because of its abundance of lymphoid follicles, thus resulting in narrowing of the lumen and obstruction. The small intestine shows areas of stricture and fibrosis, most pronounced at the terminal ileum. As a result, there is shoening of the bowel with the caecum being pulled up into a subhepatic position.Ref: Bailey and Love 27e pg: 79
Swallowed infected sputum is the cause
Highly virulent compared to ulcerative type
Serosa studded with tubercles
Pulled up Caecum
General surgery