”Peritoneal TB: A Challenging Presentation in a Young Woman with Acute Abdominal Symptoms”Samira Dehghani1, Saloomeh Mohammadi2, Atefeh Mahmoudi1, Fatemeh Riyahi Zaniyani3, Sasan Shafiei4, Afrouz Emzaei5, Yasaman Tavakoli6, Roozbeh Narimani Javid7, Athena Behforouz1*1. Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran2. Department of Pathology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran3. Faculty of Medicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran4. Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran5. Hojjat Hospital, Isfahan University of Medical Sciences, Isfahan, Iran6. Student Research Committee, Department of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran7. Student Research Committee, Hamadan University of Medical Sciences, Hamadan, IranAbstractIntroduction: Tuberculosis (TB) is a significant health problem worldwide. The rate of active tuberculosis in pregnancy is rising and it is a considerable cause of maternal mortality during pregnancy.Case presentation: This study reports a young woman who was suffering from TB peritonitis, a rare, highly progressive clinical course following the spontaneous abortion of 16-week gestation. She underwent a diagnostic laparotomy that showed several small-scale implants on the peritoneum and viscera. Histopathology revealed chronic caseating granulomas with necrosis. With the possible diagnosis of tuberculosis, anti-mycobacterial therapy was initiated and she received these drugs for 6 months. The patient’s clinical manifestations completely disappeared and the chest CT scan became normal after the treatment.Conclusion: The diagnosis of peritoneal tuberculosis is challenging and it could be made with a combination of CT imaging, explorative laparoscopy, and evaluation of biopsies from specimens and culture or PCR from ascites fluid, or infected tissues.Keywords: TB, peritoneal tuberculosis, extrapulmonary tuberculosis, acute abdomen, pregnancy
