Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION. In Ecuador, 6,094 new cases of tuberculosis were diagnosed in 2018. Most of these occurred in the coastal region. Extrapulmonary presentations cover a minority of cases and abdominal tuberculosis (intestinal and peritoneal) only represents 2.5%, however, this prevalence is increasing due to the increased survival of immunosuppressed patients. The clinical manifestations of this are non-specific and can present as ulcerative or stenosing forms (intestinal tuberculosis) and ascites or adhesion (peritoneal tuberculosis) and may be like Crohn’s disease and peritoneal carcinomatosis, respectively. The management of uncomplicated abdominal tuberculosis is carried out with an antifimic scheme like that used in pulmonary tuberculosis, reserving surgery for cases of intestinal perforation or obstruction, fistulas, abscesses, or hemorrhage. CLINICAL CASE. A 28-year-old male patient with a history of lymphoproliferative disease under study presented symptoms of acute abdomen secondary to intestinal perforation, identifying during the surgical period multiple irregular lymphadenopathies with production of caseous secretion, with histopathological results of peritoneal and intestinal tuberculosis, requiring multiple surgical interventions for formation of intestinal fistulas. DISCUSSION. Abdominal tuberculosis occurs predominantly in young adults, generally affecting the ileocecal region, with acute abdomen being a rare presentation, so there are no recommendations for the surgical management of these complications. We recommend that general characteristics be taken into consideration for the management of fistulas from other inflammatory/infectious causes, being essential the time in which the surgical resolution is planned. CONCLUSION. Tuberculosis is a public health problem that can affect different organs and systems, implying that its symptoms will be diverse and non-specific, requiring high clinical and epidemiological suspicion to make a timely diagnosis and treatment that improves the patient’s prognosis and quality of life.
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