Primary Abdominal Tuberculosis Presenting as Peritonitis: Experience at an Emergency Medical Unit in the War Zone

Abstract

Tubercular disease is a global health problem, but it is more prevalent in developing countries. Emergency surgery for complicated abdominal tubercular disease in a war zone is challenging as the confirmation of definite diagnosis is difficult and delayed. We are presenting a case of abdominal tubercular disease complicated with peritonitis from intestinal perforation in a young female, diagnosed as acute surgical abdomen, and undergone emergent exploratory laparotomy at a “Médecins Sans Frontières” (MSF) Emergency Medical Unit in the war zone of Lankien-South Sudan. She was managed with abdominal washouts and intestinal stoma; diseased tissues and ascitic fluid were taken for histopathology and cultures. A Bogota Bag was used for abdominal closure. The patient was timely but empirically put on anti-tubercular therapy, and she was transferred to a primary hospital on the 20th postoperative day to continue her treatment. We were informed that her primary abdominal tuberculosis was confirmed by histopathology from intraoperatively obtained tissues and she was doing well during a three-month follow-up.