ACUTE ABDOMINAL PAIN DUE TO PERITONEAL TUBERCULOSIS IN A 45-YEAR-OLD MALE PATIENT WITH NO MEDICAL HISTORY. CASE REPORT

Abstract

DOI: https://doi.org/10.46296/gt.v8i15.0241

Introduction: Tuberculosis, commonly known as TB, continues to be a significant global challenge, with high rates of illness and death affecting millions of people in various countries. It ranks tenth among the leading causes of death worldwide. This reactivation usually occurs through hematogenous dissemination, i.e., spread through the bloodstream from a previously affected primary pulmonary focus. The clinical presentation of this condition is often nonspecific and insidious, meaning that it can be difficult to identify in its early stages. The symptoms that most commonly present in this condition are fluid accumulation in the abdomen, known as ascites, as well as discomfort or pain in the abdominal area, a noticeable reduction in body weight, and the presence of fever. The diagnosis of pleural tuberculosis (PTB) is usually made incidentally, i.e., unintentionally, and this occurs in most cases during the evaluation or treatment of an acute abdomen requiring surgery. Clinical case: A 45-year-old male patient reports a clinical picture lasting 3 months characterized by mild generalized abdominal pain Eva 5/10, accompanied by hyporexia, anorexia, and weight loss. Evolution: Tests show leukocytosis, thrombosis, and altered electrolytes with hyponatremia. Physical examination reveals a positive ascites wave. During hospitalization, abdominal pain persisted and endoscopy showed no infection. Paracentesis was performed due to persistent ascites, and diffuse abdominal pain worsened with a fever above 38 degrees. Antibiotics were started and an emergency laparotomy was scheduled. Conclusions: The wet form of peritoneal tuberculosis, commonly known as wet PBT, is mainly distinguished by the significant presence of ascites, as it is a type of exudate containing a high level of protein. In order to make a proper diagnosis, a peritoneal biopsy is required.

Keywords: acute abdomen, Tuberculosis, Laparotomy.