Ouskri Salim, Zaoui Youssef, Boualaoui Imad, Ibrahimi Ahmed, El Sayegh Hachem, Nouini Yassine
Ibn Sina University Hospital Center, Rabat, Morocco.
Ibn Sina University Hospital Center, Rabat, Morocco.
Int J Surg Case Rep. 2025 Feb;127:110763. doi: 10.1016/j.ijscr.2024.110763. Epub 2025 Jan 5.
Tuberculosis (TB) remains a significant public health issue, especially in developing countries where its incidence is rising due to factors like overcrowding and immunosuppression. Among extrapulmonary TB forms, abdominal TB is common, while retroperitoneal TB is rare and often challenging to diagnose due to its similarity to other retroperitoneal tumors. Diagnosis typically requires invasive procedures such as laparoscopy or laparotomy.
We report the case of a 45-year-old woman with Pott's disease leading to a large retroperitoneal tuberculous abscess. She presented with a right flank mass, chronic low back pain, weight loss, and fever. Imaging revealed spondylodiscitis at the L1-L2 vertebrae and a retroperitoneal collection. PCR confirmed Mycobacterium tuberculosis. Treatment involved abscess drainage and a 9-month anti-TB regimen.
Retroperitoneal TB presents with non-specific symptoms, often delaying diagnosis. Imaging plays a crucial role in identifying abscesses, with CT and MRI being key tools. The treatment of retroperitoneal tuberculous abscesses includes surgical drainage and prolonged anti-tuberculosis therapy. Early diagnosis and a multidisciplinary approach are essential to managing this severe form of extrapulmonary TB.
Retroperitoneal tuberculous abscesses, though rare, represent a severe form of extrapulmonary tuberculosis that requires increased clinical vigilance.
结核病仍然是一个重大的公共卫生问题，尤其是在发展中国家，由于过度拥挤和免疫抑制等因素，其发病率正在上升。在肺外结核形式中，腹部结核很常见，而腹膜后结核则很罕见，并且由于其与其他腹膜后肿瘤相似，常常难以诊断。诊断通常需要诸如腹腔镜检查或剖腹手术等侵入性程序。
我们报告了一例45岁女性因脊柱结核导致巨大腹膜后结核脓肿的病例。她表现为右侧腰部肿块、慢性腰痛、体重减轻和发热。影像学检查显示L1-L2椎体脊椎间盘炎和腹膜后积液。聚合酶链反应证实为结核分枝杆菌。治疗包括脓肿引流和9个月的抗结核治疗方案。
腹膜后结核表现为非特异性症状，常常延迟诊断。影像学检查在识别脓肿方面起着关键作用，CT和MRI是关键工具。腹膜后结核脓肿的治疗包括手术引流和长期抗结核治疗。早期诊断和多学科方法对于管理这种严重的肺外结核形式至关重要。
腹膜后结核脓肿虽然罕见，但代表了一种严重的肺外结核形式，需要提高临床警惕性。
