Peritoneal Tuberculosis and the Associated Diagnostic Challenges in Gynecology: A Case Report

Peritoneal tuberculosis should be considered in young patients presenting with non-specific abdominal pain, constitutional symptoms and ascites. Here, we describe a case of a 29-year-old woman with pelvic pain, abdominal distension and weight loss. She presented with a distended, painful abdomen, and painful mobilization of the uterus and adnexa. Imaging revealed multiloculated adnexal formations, ascites and peritoneal thickening. A diagnostic laparoscopy was performed, with findings suggestive of peritoneal carcinomatosis, but the biopsies were compatible with granulomatous peritonitis. The definitive diagnosis was confirmed by cultural growth of <i>Mycobacterium tuberculosis</i>, so the patient started antituberculosis treatment. This case illustrates the difficulty in establishing the differential diagnosis between peritoneal carcinomatosis and granulomatous peritonitis.