Challenging diagnosis of abdominal tuberculosis in children: case report

Tuberculosis (TB) remains a significant cause of morbidity and mortality in the modern world. Abdominal TB is a rare form of extrapulmonary TB that has been found to affect children without comorbidities in particular, although exact numbers are unavailable because of lack of data and its rarity. The diagnosis of abdominal TB remains a challenge because of its unspecific clinical features and unclear recommendations regarding the best diagnostic tools. We report 4 cases of children with abdominal TB diagnosed at The Hospital of Lithuanian University of Health Sciences Kaunas clinics from 2008 to 2018 at the Department of Paediatric Surgery. All these cases are exceptional. The final diagnosis of abdominal TB was confirmed only after diagnostic laparoscopy and biopsy. Moreover, we suggest that QuantiFERON test and ascitic fluid analysis with serum ascites albumin gradient and adenosine deaminase tests should be performed before more invasive interventions. Laparoscopy with biopsy should be performed only in unclear cases.