[Laparoscopy can be used to diagnose peritoneal tuberculosis]

Area of Science:

• Infectious Diseases
• Gastroenterology
• Abdominal Imaging

Background:

• Tuberculosis (TB) is a significant global health concern, primarily affecting the lungs but capable of manifesting in extrapulmonary sites.
• Peritoneal tuberculosis, a form of abdominal TB, often presents with vague symptoms, making early diagnosis challenging.
• Atypical presentations of tuberculosis can mimic other conditions, complicating diagnostic pathways.

Observation:

• A 17-year-old male presented with prolonged weight loss, abdominal pain, and fever.
• Initial investigations including laboratory tests (leukocytosis, low hemoglobin) and CT scans revealed non-specific abdominal abscesses.
• Diagnostic laparoscopy identified widespread pale nodules on the peritoneum, suggesting an unusual pathology.

Findings:

• The patient was diagnosed with peritoneal tuberculosis based on laparoscopic findings and subsequent biopsy.
• This case highlights that tuberculosis can manifest atypically in diverse geographical locations, including Denmark.
• Laparoscopy proved to be an effective diagnostic tool for peritoneal tuberculosis when conventional imaging is non-specific.

Implications:

• Clinicians should consider atypical presentations of tuberculosis, including peritoneal involvement, in patients with persistent, unexplained abdominal symptoms.
• Laparoscopy with peritoneal biopsy should be considered in the diagnostic workup for suspected peritoneal tuberculosis, especially when non-invasive methods are inconclusive.
• This case underscores the importance of maintaining a high index of suspicion for tuberculosis in differential diagnoses, regardless of geographic location or typical disease patterns.