ABDOMINAL TUBERCULOSIS. CLINICAL OBSERVATION AND REVIEW OF THE LITERATURE

Summary. Tuberculosis is a common infectious anthropozoonotic disease without organotropy. Abdominal tuberculosis is a specific tuberculous lesion of the digestive organs, lymph nodes of the mesentery and retroperitoneal space, peritoneum, liver and gallbladder, spleen. Lethality in case of untimely diagnosed abdominal tuberculosis reaches 86%. Material and methods. The clinical observation of the detection of abdominal tuberculosis in a woman referred for treatment with abdominal pain and suspicion of a suppurative cyst of the urachus is presented. Laparoscopy was performed and abdominal tuberculosis was suspected. The operative material was subjected to molecular genetic (PCR) and pathomorphological examination.Results. A 31-year-old woman was referred and hospitalized to the urology clinic of Avicenna SC "Mother and Child" with complaints of pain in all parts of the abdomen, more in the perineal area, temperature increase up to 38.50C. Pain and discomfort appeared 1 week before the complaint. The patient was known to be on antiretroviral therapy for HIV infection, had short-term contact with a patient with an open form of pulmonary tuberculosis. MSCT showed signs of urachus cysts with the presence of effusion in the abdominal cavity. A concilium determined indications for diagnostic laparoscopy, which revealed prosovaginal rashes on the parietal and visceral peritoneum, suspected of tuberculosis, performed peritoneal biopsy and fluid sampling for PCR study for tuberculosis. Both studies confirmed the disease.Conclusion. The basis of early diagnosis is a high degree of vigilance against tuberculosis. The peculiarity of this case was that a physician familiar with the property of tuberculosis to masquerade as nonspecific manifestations was involved in the treatment. A high suspicion of tuberculosis was crucial in determining the indications for diagnostic laparoscopy and taking the material for histological and molecular genetic examination, which allowed to make the correct diagnosis without delay and refer the patient to the TB dispensary for further treatment.