”Peritoneal TB: A Challenging Presentation in a Young Woman with
Acute Abdominal Symptoms”
Samira Dehghani1, Saloomeh
Mohammadi2, Atefeh Mahmoudi1,
Fatemeh Riyahi Zaniyani3, Sasan
Shafiei4, Afrouz Emzaei5, Yasaman
Tavakoli6, Roozbeh Narimani Javid7,
Athena Behforouz1*
1. Preventive Gynecology Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
2. Department of Pathology, Mahdieh Hospital, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
3. Faculty of Medicine, Islamic Azad University, Tehran Medical Sciences
Branch, Tehran, Iran
4. Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
5. Hojjat Hospital, Isfahan University of Medical Sciences, Isfahan,
Iran
6. Student Research Committee, Department of Medicine, Mazandaran
University of Medical Sciences, Mazandaran, Iran
7. Student Research Committee, Hamadan University of Medical Sciences,
Hamadan, Iran
AbstractIntroduction: Tuberculosis (TB) is a significant health problem
worldwide. The rate of active tuberculosis in pregnancy is rising and it
is a considerable cause of maternal mortality during pregnancy.
Case presentation: This study reports a young woman who was
suffering from TB peritonitis, a rare, highly progressive clinical
course following the spontaneous abortion of 16-week gestation. She
underwent a diagnostic laparotomy that showed several small-scale
implants on the peritoneum and viscera. Histopathology revealed chronic
caseating granulomas with necrosis. With the possible diagnosis of
tuberculosis, anti-mycobacterial therapy was initiated and she received
these drugs for 6 months. The patient’s clinical manifestations
completely disappeared and the chest CT scan became normal after the
treatment.
Conclusion: The diagnosis of peritoneal tuberculosis is
challenging and it could be made with a combination of CT imaging,
explorative laparoscopy, and evaluation of biopsies from specimens and
culture or PCR from ascites fluid, or infected tissues.
Keywords: TB, peritoneal tuberculosis, extrapulmonary
tuberculosis, acute abdomen, pregnancy