Xu Yaying Eileen, Tan Kimberley, Hendahewa Rasika
General Surgical Department, Caboolture Hospital, Brisbane, 4510, Australia.
J Surg Case Rep. 2019 Dec 27;2019(12):rjz361. doi: 10.1093/jscr/rjz361. eCollection 2019 Dec.
Intra-abdominal tuberculosis (TB) is rare in Australia, but it can be found in those who emigrate from endemic areas. We report a rare case of a 28-year-old lady from the Philippines who presented with abdominal pain, ascites and an elevated cancer antigen (CA) 125 with an initial concern of ovarian malignancy. She underwent a diagnostic laparoscopy which revealed typical features of intra-abdominal TB and histological features of granulomatous inflammation. The symptoms and signs of intra-abdominal TB are non-specific and can mimic many other conditions. The gold-standard mode of diagnosis in intra-abdominal TB is laparoscopy with tissue biopsy. Ovarian malignancy is relatively rare in pre-menopausal women; hence an elevated CA 125 warrants a broader differential diagnosis. It is important to have intra-abdominal TB as a differential even in the non-endemic settings to avoid delay in diagnosis and appropriate management.
腹腔结核在澳大利亚较为罕见，但在来自疫区的移民中可能会出现。我们报告了一例罕见病例，一名28岁来自菲律宾的女性，出现腹痛、腹水和癌抗原（CA）125升高，最初怀疑为卵巢恶性肿瘤。她接受了诊断性腹腔镜检查，结果显示为腹腔结核的典型特征以及肉芽肿性炎症的组织学特征。腹腔结核的症状和体征不具有特异性，可模仿许多其他病症。腹腔结核的金标准诊断方法是腹腔镜检查及组织活检。卵巢恶性肿瘤在绝经前女性中相对少见；因此，CA 125升高需要进行更广泛的鉴别诊断。即使在非疫区，将腹腔结核作为鉴别诊断也很重要，以避免诊断和适当治疗的延误。
