Akbulut Sami, Arikanoglu Zulfu, Basbug Murat
Department of Surgery, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey.
J Med Case Rep. 2011 Aug 10;5:363. doi: 10.1186/1752-1947-5-363.
Female genital tuberculosis is a rare form of extrapulmonary tuberculosis. It is an asymptomatic disease usually diagnosed during the search for causes of infertility. However, it can present with a number of abdominopelvic symptoms. Herein we report a case of tubo-ovarian tuberculosis mimicking acute appendicitis.
A 17-year-old single Turkish woman presented to our hospital with complaints of right lower quadrant abdominal pain, nausea, and vomiting. Her physical examination findings, ultrasonogram, and leukocyte count were consistent with acute appendicitis. A cystic mass (15 cm × 6 cm) was detected on the right tubo-ovarian structure by laparotomy. The mass was excised while the tubo-ovarian structures were preserved and the need for an appendectomy was avoided. No microbiological evaluation was performed. The histopathological examination of the cystic mass revealed a granuloma with central caseating necrosis surrounded by epithelioid histiocytes. The patient was treated with anti-tuberculosis therapy for six months. No recurrence was observed during a 10-month follow-up period.
Genital tuberculosis should be considered in the differential diagnosis of right lower quadrant pain in women who live in tuberculosis-endemic regions.
女性生殖器结核是肺外结核的一种罕见形式。它是一种无症状疾病，通常在寻找不孕原因时被诊断出来。然而，它可能会出现一些腹盆腔症状。在此，我们报告一例酷似急性阑尾炎的输卵管卵巢结核病例。
一名17岁的单身土耳其女性因右下腹痛、恶心和呕吐前来我院就诊。她的体格检查结果、超声检查和白细胞计数均与急性阑尾炎相符。剖腹手术时在右侧输卵管卵巢结构上发现一个囊性肿块（15厘米×6厘米）。在保留输卵管卵巢结构的同时切除了肿块，避免了阑尾切除术的需要。未进行微生物学评估。囊性肿块的组织病理学检查显示有一个肉芽肿，中央为干酪样坏死，周围是上皮样组织细胞。该患者接受了六个月的抗结核治疗。在10个月的随访期内未观察到复发。
对于生活在结核病流行地区的女性，右下腹痛的鉴别诊断应考虑生殖器结核。
