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Abdominal tuberculosis: An old disease surprising young surgeons

A 21-year-old male with no prior illnesses presented to the emergency department with features of small bowel obstruction. Contrast-enhanced computed tomography of the abdomen showed features of ileal obstruction and contained perforation secondary to probable Crohn's disease. However, on exploratory laparotomy, he underwent adhesiolysis, terminal ileal resection, and end ileostomy. The biopsy showed multiple tubercles and other pathognomic characteristics of tuberculosis (TB). The findings were conclusive of abdominal TB involving the peritoneum and terminal ileum. On initiation of antitubercular therapy, his condition improved symptomatically, and he was subsequently discharged. Although the prevalence of TB has been declining in recent times, it still remains a major public health problem in our country. Abdominal TB is known to mimic multiple other conditions, and a high index of suspicion is needed to initiate appropriate therapy, thereby preventing morbidity and mortality. It is therefore crucial that young surgeons familiarize themselves with all the different manifestations of abdominal TB.