Peritoneal tuberculosis - a gynecologist's dilemma

ABSTRACT

Tuberculosis [TB] can involve the entire gastrointestinal tract [GI] including the peritoneum and the pancreatobiliary system. Tuberculous infection of the peritoneum is rare in developed, countries but significant in countries with a high prevalence of TB. It is commonly seen in individuals less than 40 years of age with female predominance. It can be found in pulmonary and extra pulmonary sites. The case reported here is of tuberculous peritonitis in a 30 years old female which was diagnosed incidentally during caesarean section and was kept on antitubercular treatment [ATT]. She did not respond to ATT. Laparotomy was performed because of increasing pain, abdominal distension and multicystic lesions in ovaries. ATT alone may be an effective treatment in pelvic-peritoneal tuberculosis, obviating the need for invasive methods. Indications for surgery may include persistence of pelvic mass and recurrence of pain or bleeding after 9 months of ATT