Abdominal tuberculosis and thrombosis of inferior vena cava: a case report

Introduction: Tuberculosis (TB) is an ancient disease. At the present, about 9 million people are suffering from the disease, and about 3 million people die due to TB and its complications. Abdominal or Gastrointestinal tract TB is the sixth most frequent site of extrapulmonary involvement. Diagnosis of abdominal TB is very difficult since it appears with multiple symptoms. In this study, we describe a case of abdominal TB with rare presentation of IVC thrombosis that was evaluated for a long time without any results. Case Report: The patient was a 31-year-old woman - with history of chronic abdominal pain for 6 months - hospitalized at internal ward at Shahid Mohammadi hospital in Bandar Abbas, Iran. Abdominal sonography and CT scan showed a 15*50 mm thrombosis in IVC. Physicians started anticoagulant therapy since they did not reach an appropriate diagnosis. After 2 to 3 months the abdominal pain was intensified and the patient was referred to a surgeon. Appendicular abscess was diagnosed and open surgery was an option for the removal of the abscess. During the surgery, the surgeon tried to drain the abscess from the preperitoneal space but, a big mass - separate from the abscess - was noted in the area. Pathological examinations of the mass showed that the cause of the problem was TB granuloma. Being treated with anti TB medication, the patient recovered. Conclusion: Abdominal TB entailed various symptoms making the diagnosis controversial. Hence, strong clinical suspicion is a critical factor for the diagnosis of the disease in endemic regions. PCR test of ascites is very useful. Definite diagnosis is made by biopsy of peritoneal white nodules at the time of laparoscopy or laparotomy. The disease responds well to drug therapy. Therefore, on time diagnosis saves time and money