Appendicular Base Perforation as a Rare Manifestation of Abdominal Tuberculosis in a Paediatric Patient: A Case Report

Pulmonary tuberculosis is the most commonly diagnosed site of tuberculosis infection in children and abdominal tuberculosis accounts for only 0.3-4% of all tuberculosis cases, especially in Indian children. Although India has made progress in reducing overall TB incidence in recent years, abdominal TB remains a rare and potentially life-threatening complication that presents diagnostic and therapeutic challenges. Here, in this case report, a 13-year-old female presented to the Department of Gastroenterology at a tertiary health-care centre. The patient presented with abdominal pain, fever and vomiting, with a history of abdominal distension. Imaging revealed inflammatory changes with perforation. During emergency laparoscopic appendectomy, perforation at the base of the appendix was identified along with multiple peritoneal granulomas. Histopathological examination and the CartridgeBased Nucleic Acid Amplification Test (CBNAAT) were performed. After confirmation of the diagnosis, the patient was started on antitubercular therapy according to national guidelines and responded well to treatment. This case emphasises the importance of considering TB in atypical presentations of appendicitis, especially in children.