Tuberculous peritonitis in pregnancy: a case report

Tuberculous peritonitis is one of the least common forms of extrapulmonary tuberculosis. In the literature, few cases in pregnancy have been previously published. Tuberculous peritonitis in pregnancy is a diagnostic challenge, especially in the absence of lung involvement. It mimics other diseases and clinical presentation is usually non-specific, which may lead to diagnostic delay and development of complications.

We report here a new case of tuberculous peritonitis that occurred in a 31-year-old Caucasian pregnant woman at 22 weeks' gestation. She was complaining of abdominal pain, nausea and vomiting. These symptoms appeared 6 months prior to presentation. Initially, they were attributed to pregnancy, but they progressively became more severe during subsequent weeks. A laparoscopy showed the presence of yellow-white nodules on the peritoneal surface and a biopsy demonstrated caseous necrotic granuloma. She made a good physical recovery after being placed on antituberculous chemotherapy and gave birth to a healthy male neonate of 3100g at 37 weeks' gestation by vaginal delivery.

Extreme vigilance should be used when dealing with unexplained abdominal symptoms to ensure timely diagnosis of tuberculous peritonitis. Diagnosis often requires a histopathological examination. In these patients early diagnosis with early antituberculous therapy are essential to prevent obstetrical and neonatal morbidity.