Abdominal miliary tuberculosis : acute abdomen mimicking perforated uterus

Abstract EN

Miliary tuberculosis in pregnancy is very uncommon, but when it is present, its unusual presentation may raise difficulties in diagnosis.

We report a young patient who presented with abdominal pain, abdominal distension, loss of appetite, low-grade fever, anemia, and ascities.

Her symptoms began 5 days after evacuation procedure for an incomplete abortion.

She had no respiratory symptoms and a normal chest x ray.

She was HIV seronegative.

Ultrasonography showed an empty uterus, extrauterine mass, and free peritoneal fluid.

She was admitted with a diagnosis of perforated uterus vs.

ectopic pregnancy.

Abdominal paracentesis was performed which revealed clear ascitic fluid, raising the suspicion of abdominal miliary tuberculosis.

This diagnosis was confirmed by laparotomy and histological examination.

The patient improved with antituberculous treatment with rifampin, streptomycin, and pyrazinamide.