Peritoneal Tuberculosis and the Associated Diagnostic Challenges in Gynecology: A Case Report

Peritoneal tuberculosis should be considered in young patients presenting with non-specific abdominal pain, constitutional symptoms and ascites. Here, we describe a case of a 29-year-old woman with pelvic pain, abdominal distension and weight loss. She presented with a distended, painful abdomen, and painful mobilization of the uterus and adnexa. Imaging revealed multiloculated adnexal formations, ascites and peritoneal thickening. A diagnostic laparoscopy was performed, with findings suggestive of peritoneal carcinomatosis, but the biopsies were compatible with granulomatous peritonitis. The definitive diagnosis was confirmed by cultural growth of Mycobacterium tuberculosis, so the patient started antituberculosis treatment. This case illustrates the difficulty in establishing the differential diagnosis between peritoneal carcinomatosis and granulomatous peritonitis.