Abdominal tuberculosis: a misleading condition still encountered

BACKGROUND: Extrapulmonary manifestations of tuberculosis are increasing in incidence Abdominal tuberculosis may mimic a variety of gastrointestinal d isorders. The diagnosis of abdominal tuberculosis is still difficult to est ablish before surgery. CASE REPORTS: We report 3 cases of abdominal tuberculosis in immunocompeten t individuals. One patient presented with an ileocecal mass mimicking cance r. The second one presented with fever, ileocecal mass and ascites leading to the diagnosis of appendiceal peritonitis. The last patient was admitted for ascites, ovarian mass and high CA 125 serum level simulating ovarian ca ncer with peritoneal carcinomatosis. COMMENTS: In cases of abdominal tuberculosis when standard investigations a re unhelpful, a PCR should be performed. Estimation of adenosine deaminase in ascitic fluid is an easy and reliable method for diagnosing tuberculous ascites. With these non invasive diagnostic procedures, surgery should be r eserved only to patients with complications.