Abdominal tuberculosis: experience with three cases from an Austrian centre

Abstract

BACKGROUND: Tuberculosis has remained an important infectious threat in the third world, but is relatively rare in industrialized countries. Peritoneal tuberculosis is a diagnostic challenge since its clinical presentation and radiological findings may mimic peritoneal carcinosis associated with gynaecological or gastrointestinal cancer. METHODS: Two patients with peritoneal and one with gastrointestinal tuberculosis are presented. RESULTS: Three women with unspecific abdominal symptoms were admitted to the hospital. In two patients the suspected initial diagnoses based on radiological findings were gastric and ovarian cancer with peritoneal spread. The correct diagnoses were made upon laproscopy and subsequent histopathological examination. The third patient presented with abdominal pain and bloody diarrhea six years after renal transplantation and intestinal tuberculosis was diagnosed on colonoscopy. All three cases were successfully managed with combination anti-microbial therapy. In one patient, multidrug-resistant Mycobacterium tuberculosis strain was involved. CONCLUSIONS: Abdominal tuberculosis can present with clinical and radiological signs of gastrointestinal or gynaecological cancer. Laparoscopy and endoscopy with tissue biopsies can readily establish diagnosis.