Pseudotumoral Abdominal Tuberculosis in Immunocompetent Adults: Report of Three Cases and Review of the Literature

Purpose: To highlight diagnostic challenges of pseudotumoral abdominal tuberculosis. Materials and methods: Three cases of pseudotumoral abdominal tuberculosis were compiled in our department between 2014 and 2015. They were aged 34 years, 42 years and 61 years respectively. They were immunocompetent and had no personal or family history of tuberculosis. Clinical presentations were non-specific, represented by abdominal pain and weight loss in the three patients and chronic diarrhea in one patient. Abdominal ultrasound and computed tomography CT were performed in all patients. Abdominal MRI was performed in one case as well as a colonoscopy. Results: Retroperitoneal tuberculosis and colic tuberculosis were noted in the 1st and 2nd case. Macro-nodular and biliary hepatic tuberculosis was retained in the third case. The diagnosis was based upon histopathology in the 3 cases showing tubercular granuloma with caseation. Anti-tuberculosis therapy was prescribed for 6 months. Evolution was favorable in all patients. Conclusion: Tuberculosis continues to present diagnostic difficulties, particularly in its pseudo-tumoral form, even in endemic tuberculosis countries like ours.