Small bowel obstruction secondary to abdominal tuberculosis

Tuberculosis (TB) remains a serious public health concern in developing countries to date. Gastrointestinal involvement secondary to pulmonary TB is seen in 55-90% of the adult population. Intestinal TB is prevalent in immunosuppressed patients in underdeveloped countries and constitutes 12% of extrapulmonary TB cases. However, it poses a diagnostic challenge due to its non-specific features and underlying complications. Intestinal TB often involves the GI tract, peritoneum, mesenteric lymph nodes, and solid viscera of the abdomen. Here we present a known case of TB in a 39-year-old female, non-compliant with anti-TB medications. She presented with complaints of diffuse abdominal pain, generalized weakness and constipation. She was suspected of having small bowel obstruction. On evaluation, the Mantoux test was positive and the spread of extrapulmonary TB in the form of multiple calcified granulomas was seen in solid visceral organs such as the liver and spleen, along with omentum and mesenteric lymph nodes, which we believed was a rare clinical presentation in Intestinal TB cases. The patient was surgically managed and discharged in stable condition.