Case Report in an Adolescent Patient with Diagnosis and Management of Abdominal Tuberculosis

This case report describes a 14-year-old boy with abdominal tuberculosis presenting with persistent vomiting. He was referred from Genteng Jember Hospital to the emergency department at Dr. Soetomo Surabaya Hospital after being initially suspected of having an intra-abdominal mass. Clinical assessment included physical examination, head-neck evaluation, laboratory hematology, plain abdominal radiograph (foto BOF), and abdominal CT scan. The foto BOF showed a normal distribution of intestinal gas in the pelvic cavity, with no signs of obstructive ileus or pneumoperitoneum. Based on clinical and radiological findings, a diagnosis of abdominal tuberculosis was established. Treatment consisted of anti-tuberculosis therapy: RHZE (Rifampicin, Isoniazid, Pirazinamid, Etambutol) for two months, followed by RH for six to nine months, with doses adjusted to the patient’s 40 kg body weight using the adult fixed-dose combination OAT (KDT), three tablets daily. The patient was closely monitored for therapeutic response and potential drug side effects. Clinical and microscopic improvement was used to assess healing. This case highlights the need for heightened suspicion of abdominal tuberculosis in children with nonspecific symptoms and imaging suggestive of intra-abdominal masses. Early diagnosis and appropriate, closely monitored therapy can lead to favorable outcomes and prevent complications. Vigilance is crucial when encountering pediatric patients with atypical abdominal presentations, as abdominal tuberculosis can mimic other intra-abdominal pathologies.