Tuberculosis of the colon commonly involves the ascending,transverse, or sigmoid colon while rectal involvement in tuberculosis is uncommon and poorly characterized. We report a six-year-old male from Nepal who presented with abdominal pain and difficulty passing stool for two years. On per rectal examination, palpation revealed a circumferential rectal mass. On further evaluation, CT scan showed mural thickening and luminal narrowing in the ano-rectum. Colonoscopy with biopsy showed caseating granuloma and positive acid fast bacilli culture consistent with tuberculosis. After starting anti-tubercular therapy, the patient's abdominal pain resolved and the patient was able to pass stool normally within two weeks. Colonoscopy three months after starting treatment showed complete resolution of the mass. Gastrointestinal tuberculosis should be considered in cases of children from endemic areas who present with a rectal mass.
Keywords: Anorectal tuberculosis; Colonoscopy; Gastrointestinal tuberculosis; Nepal; Pediatric tuberculosis.