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Case Report
Abdominal tuberculosis masquerading as carcinomatosis: Not difficult to miss!
1 Acute Clinical Fellow, General Surgery, Royal Derby Hospital, Derby, United Kingdom
2 Registrar, General Surgery, Royal Derby Hospital, Derby, United Kingdom
3 Consultant, Vascular Surgery, Royal Derby Hospital, Derby, United Kingdom
Address correspondence to:
Christiana O Fabelurin
No. 46 Auriga Court, Little Chester, Derby, DE1 3RH,
United Kingdom
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Article ID: 101208Z01CF2021
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Fabelurin CO, Arora D, Abayasekara K. Abdominal tuberculosis masquerading as carcinomatosis: Not difficult to miss! Int J Case Rep Images 2021;12:101208Z01CF2021.ABSTRACT
Introduction: Abdominal tuberculosis (ATB) is a rare extrapulmonary manifestation of Mycobacterium tuberculosis infection. It usually presents with non-specific symptoms that can mimic other intra-abdominal conditions like acute appendicitis, Crohn’s disease, ovarian pathology, and intra-peritoneal carcinomatosis and is therefore, easy to overlook. Diagnosing ATB in the pediatrics population tends to be even more challenging as an obvious history of exposure may be difficult to obtain. Chronicity of symptoms and lack of Bacillus Calmette-Guérin (BCG) scar should raise suspicion. Diagnostic laparoscopic biopsy and histopathology provides definitive diagnosis.
Case Report: This case report presents the case of a 16-year-old girl with a history of recurrent abdominal pain, vomiting, and pyrexia. At initial diagnostic laparoscopy, she underwent laparoscopic appendectomy. Vesicles were noted in the pelvis. The patient failed to improve. Exposure to tuberculosis (TB) was denied. Review of pre-operative computed tomography (CT), comprehensive re-laparoscopy, and histopathology of appendix were used for final diagnosis of this condition. The patient was treated using anti-TB therapy for six months following which, she was able to make a full recovery.
Conclusion: Abdominal TB is very difficult to diagnose in young patients and should be considered in those presenting with vague, recurrent, or persistent abdominal symptoms. A high index of suspicion is needed for early diagnosis and prompt treatment of this condition. In patients with low or no identifiable risk factors for TB, definitive diagnosis is justified prior to the initiation of therapy.
Keywords: Abdominal cavity, Pediatrics, Peritonitis, Tuberculosis
SUPPORTING INFORMATION
Author Contributions
Christiana O Fabelurin - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Deeksha Arora - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kumar Abayasekara - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementThere was no written consent obtained from this patient as there were no patient identifying factors used in the article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Christiana O Fabelurin et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
