Abdominal Tuberculosis Presenting as an Umbilical Sinus: A Case Report.

Area of Science:

• Medicine
• Infectious Diseases
• Radiology

Background:

• Abdominal tuberculosis (TB) is a significant extrapulmonary manifestation, particularly prevalent in developing nations like India.
• It frequently affects human immunodeficiency virus (HIV)-infected adults, presenting with diverse clinical signs.
• Diagnosis can be challenging due to its variable presentations.

Observation:

• A 26-year-old male presented with symptoms of abdominal distention, anorexia, and weight loss.
• Initial MRI revealed a large loculated fluid collection, and CT confirmed pulmonary TB.
• The patient later developed umbilical discharge with necrotic tissue, indicating a complex abdominal TB presentation.

Findings:

• The patient underwent emergency laparotomy revealing a mixed type of peritoneal tuberculosis (plastic fibrous and encysted loculated).
• This case highlights an uncommon presentation of abdominal tuberculosis with unusual external manifestations.
• Diagnostic difficulties were encountered, emphasizing the need for high clinical suspicion.

Implications:

• This case underscores the importance of considering abdominal tuberculosis in patients with unexplained abdominal symptoms, especially in immunocompromised individuals.
• It highlights the diagnostic challenges and the need for advanced imaging and surgical exploration in complex cases.
• Awareness of rare presentations is vital for timely and accurate diagnosis of abdominal TB.