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CASE REPORT
Abdominal tuberculosis: an old disease surprising young doctors
  1. Marta David Sousa1,
  2. Joana Batista2,
  3. Patricia Pacheco2,
  4. Vitor Nunes3
  1. 1B Surgery Department, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Lisboa, Portugal
  2. 2Department of Infectious Disease, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Lisboa, Portugal
  3. 3Department of Surgery—Cirurgia B, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Portugal
  1. Correspondence to Dr Vitor Nunes, hff.cirurgia{at}gmail.com

Summary

Tuberculosis remains a worldwide public health concern. Atypical extrapulmonary presentations may delay the diagnosis and treatment. We present the case of an adult woman admitted to the emergency department with bowel obstruction. The putative intraoperative diagnostic hypothesis was ovarian cancer with peritoneal dissemination. Histopathological analysis showed a chronic granulomatous inflammatory disease with acid-fast bacilli. The patient was started on an alternative parenteral antituberculosis drug combination until oral feeding was available. Currently, 5 months after surgery, she is asymptomatic. Abdominal tuberculosis is the most frequent extrapulmonary site with a wide range of clinical presentations. Emergency laparotomy may be necessary in patients who present with acute abdomen. Bowel obstruction due to adhesions and strictures is not infrequent. However, tuberculous abdominal cocoon presentation as in our patient is rare. Treatment with parenteral alternative drug regimens for tuberculosis is mandatory until the oral route is available.

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Footnotes

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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