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Peritoneal Tuberculosis Complicated by Abdominal Abscesses: Diagnostic Challenges and Clinical Insights From Two
Sarra Ben Azouz1, Myriam Ayari1, Rim Bouyahia2
1Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, Tunisia.
Summary
Peritoneal tuberculosis (PT) can mimic Crohn's disease, causing diagnostic delays. Prompt diagnosis integrating imaging, endoscopy, and molecular testing is crucial for effective treatment of this rare Mycobacterium tuberculosis infection.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Peritoneal tuberculosis (PT) is a rare extrapulmonary manifestation of Mycobacterium tuberculosis.
- PT often presents with symptoms mimicking Crohn's disease (CD) or intra-abdominal malignancy, leading to diagnostic challenges.
- Localized abscess formation can complicate PT, further obscuring the diagnosis.
Purpose of the Study:
- To highlight the diagnostic challenges of peritoneal tuberculosis.
- To illustrate how PT can present as localized abscesses mimicking Crohn's disease.
- To emphasize the importance of integrated diagnostic approaches for PT.
Main Methods:
- Case report of two patients with peritoneal tuberculosis presenting with abscesses.
- Utilized computed tomography (CT) for imaging abscesses and bowel thickening.
- Performed colonoscopy, CT-guided biopsy, laparoscopy, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis detection.
Main Results:
- Both cases presented with abdominal abscesses and ileocecal inflammation, initially suggestive of Crohn's disease.
- Microbiological and histopathological analyses confirmed peritoneal tuberculosis.
- Both patients responded well to anti-tuberculous therapy, with complete radiological resolution in one case.
Conclusions:
- Peritoneal tuberculosis can manifest as localized abdominal or psoas abscesses, closely resembling Crohn's disease.
- Early integration of imaging, endoscopy, tissue sampling, and molecular testing is essential for accurate diagnosis of PT.
- Timely diagnosis and treatment of peritoneal tuberculosis are critical for favorable patient outcomes.
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