Tuberculosis is still a major public health concern around the world. Abdominal TB is an unusual manifestation, and because it is extrapulmonary, it may take longer to diagnose and treat. Despite being a treatable condition, the mortality rate linked with treated abdominal TB is 15%. The purpose of this case study was to discuss a typical presentation of abdominal tuberculosis and to emphasise the challenges that can be faced when diagnosing this disease.
Case Presentation: A 56-year-old man was presented to the hospital with a one-week history of generalised stomach discomfort, distention, and vomiting. The chest X-ray was normal, but the abdominal X-ray revealed high levels of air-fluid. A high white cell count of 14,000l was discovered in the laboratory. Multiple tiny whitish deposits in the larger omentum and on the bowel were discovered during laparotomy, along with a frozen abdomen. Histology of gigantic Langhans multinucleated cells with acid-fast bacilli and necrosis, as well as a granulomatous inflammatory process, were seen in biopsies of these whitish deposits. Anti-tuberculosis treatment was started with a mix of medications, and he recovered without complications.
The clinical manifestations of abdominal tuberculosis include acute, subacute, and chronic illness. Our patient's chest X-ray revealed no indication of pulmonary tuberculosis, which is not surprising given that only around half of individuals with abdominal tuberculosis also have pulmonary tuberculosis. Abdominal TB ultrasound results include thickening of the ileum, caecum, and colon walls, as well as ascites. When cancer cannot be ruled out with certainty, a laparotomy with biopsy of any peritoneal lesions, omental lesions, and lymph node biopsy is advised.
Conclusions: A strong index of suspicion and careful use of diagnostic methods may aid in the rapid diagnosis and treatment of abdominal TB. To identify abdominal TB from peritoneal carcinomatosis, a biopsy of peritoneal/omental lesions as well as a mesenteric lymph node is recommended.Author(S) Details
Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.
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