Diagnosis of Peritoneum Tuberculosis during a Herniotomy

Background: Tuberculosis is still a public health problem in the third world. The peritoneal localization is common even in pediatric patients. The macroscopics aspects of the peritoneal and/or intestine granulations are pathognomonic. However, its diagnosis by an inguinal hernia is exceptional. Our work aims to discuss the particularities of this unusual presentation of peritoneal tuberculosis. Case report: A 10-year-old girl who presented with a painless inguinal hernia. In per operatory, there was a granulomatous inflammation of the vaginalis process. The diagnosis of tuberculosis was confirmed by histopathologic study and the patient started the anti-tuberculosis drugs. After one year of follow-up, the girl is good and has no symptoms. Discussion: Opinions are divided when to cure the hernia. Is it necessary to do a laparoscopic exploration and biopsy then to secondarily cure the hernia; or go through the inguinal way to cure the hernia and do a peritoneal biopsy? In our case, we performed by the same surgical time the cure of the hernia and the biopsy and it did not impact negatively the follow-up. Conclusion: This revelation mode of peritoneal tuberculosis by inguinal hernia is exceptional but possible.