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Elie R. Zaghrini, George Hasbany, Maroon Tohmeh, Wajdi Hamdan, Dima Anani, Gregory Nicolas
(Department of Emergency Medicine, Lebanese American University, Beirut, Lebanon)
Med Sci Case Rep 2018; 5:1-5
Tuberculosis, a disease caused by Mycobacterium tuberculosis, can have extra-pulmonary targets such as the abdomen, leading to abdominal tuberculosis. Abdomen involvement, which occurs in 11% of patients with extra-pulmonary tuberculosis, can pose a challenge for diagnosis if not suspected.
CASE REPORT: We present the case of a 26-year-old male patient who presented 3 times to the Emergency Department during a 1-month period for episodes of diffuse abdominal pain thought to be gastroenteritis. After 1 month, he presented for a severe diffused abdominal pain that was diagnosed by a CT scan and an small bowel obstruction due to abdominal tuberculosis, and he underwent an urgent laparotomy. Pathological analysis of the tumor should be done to confirm the diagnosis of tuberculosis by showing caseating epithelioid and giant cell granuloma. Microbiological analysis by a Ziehl-Neelson staining is required to reveal the presence of positive acid-fast bacilli.
CONCLUSIONS: Urgent laparotomy, regardless of the procedure, is recommended for tuberculous intestinal obstruction, followed by anti-tuberculous therapy.
Keywords: Antitubercular Agents, Intestinal Obstruction, Tuberculosis