A 22-year-old male underwent exploratory laparotomy after presenting with abdominal pain, fever, anorexia, night sweats, and weight loss, over one month (Fig. 1). He provided no history of close contact with TB patients, although he had history of chronic recurrent cough. This information raised a high suspicion of TB. A diagnosis of small bowel obstruction secondary to a caecal mass was made and histopathology of omental biopsy confirmed a chronic granulomatous inflammation caused by TB without any signs of malignancy (Fig. 2). He underwent a right hemicolectomy and anastomosis end-to-side to the transverse ileocolical region. The physical examination on subsequent presentation showed no adventitious breath sounds, an abdominal scar from the laparotomy, without organomegaly. However, infiltrates in both apices was shown in his chest x-ray, and an abdominal CT-scan prior his surgery was remarkable for signs of bowel obstruction. He was anemic with a haemoglobin of 9.4 g%. Sputum gram-stain revealed positive results of AFB and Diplococcus. He was then diagnosed with pulmonary and intestinal TB, therefore treated with 6 months of ATD.