Atypical form of peritoneal tuberculosis

Area of Science:

• Abdominal imaging and pathology
• Infectious disease diagnosis
• Surgical intervention

Background:

• A 48-year-old woman presented with a right flank mass and a palpable fistula.
• Initial imaging revealed an intraperitoneal tissue structure, prompting a scan-guided biopsy.

Observation:

• The initial biopsy showed non-specific inflammatory lesions.
• A purulent fistula developed at the biopsy site, necessitating a second biopsy.
• The second biopsy revealed granulomatous inflammation with caseous necrosis.

Findings:

• Histopathological examination confirmed abdominal tuberculosis.
• The diagnosis was established following the development of a fistula at the biopsy site.

Implications:

• This case highlights the importance of considering tuberculosis in the differential diagnosis of abdominal masses, especially when initial biopsies are inconclusive.
• Prompt initiation of anti-tuberculosis therapy is crucial for favorable clinical and radiological outcomes.
• The development of a fistula can be an atypical presentation of abdominal tuberculosis.