Rare Case of Abdominal Tuberculosis Presenting With Abdominal Cocoon in a Pediatric Patient

Abstract

Objective: To highlight an uncommon presentation of abdominal tuberculosis (TB) in children, with the aim of improving early detection and diagnosis, particularly in high TB burden countries like Pakistan.

Method: A clinical case of a young malnourished girl from Pakistan presenting with nonspecific abdominal symptoms was examined. Due to the diagnostic challenges in pediatric TB and the limitations of microbiological confirmation, imaging techniques were employed. A Computerised Tomography (CT) scan was performed to assess her abdominal condition.

Results: The CT scan revealed an abdominal cocoon (AC), a rare form of encapsulating peritoneal sclerosis and an extremely uncommon presentation of abdominal TB. Unlike most cases of AC that are diagnosed during surgery, this case was identified radiologically, allowing for earlier medical intervention.

Conclusion: This case underscores the diagnostic difficulties associated with pediatric TB, especially its extrapulmonary forms such as abdominal TB. The identification of an abdominal cocoon through imaging highlights the importance of considering rare manifestations in children with nonspecific abdominal complaints. Early imaging can facilitate timely diagnosis and treatment, which is vital in TB-endemic regions like Pakistan.