DOI: https://doi.org/10.36347/sjmcr.2025.v13i07.048

Pages: 1710-1715

Abdominal tuberculosis accounts for 3 to 13% of extra-pulmonary tuberculosis cases. Gastrointestinal tuberculosis (GIT) is rare, and the signs are poorly recognized, leading to misdiagnosis. Purpose: To study the clinical and paraclinical epidemiological confounding factors through 04 cases observed in the digestive and proctological surgery department. Observations: One woman and three men were admitted for an abdominal surgical emergency (n=1) and a proctological emergency (n=3), respectively. The diagnosis of gastrointestinal tuberculosis was made after a diagnostic error. Confounding factors were dominated epidemiologically by HIV sero-negativity and the absence of tuberculosis infection (n=3). Associated with this were nonspecific reasons for consultation (anal suppuration (n=3) and stabbing abdominal pain (n=1). Clinical polymorphism suggested an anal fistula (n=2), respectively a fistulized prostate tumor and a gastric perforation on probable tumor. Imaging was nonspecific for the majority and the IDR was negative in all. The procedures were dominated by fistulotomy. histopathological analysis of the sampled tissues showed giant cell granulomatous inflammation in half of the cases. Xpert gene and PCR corrected the diagnosis in two cases. The evolution was morbid in all patients and one death in respiratory distress was observed. Conclusion: At the end of this study, we can say that gastrointestinal tuberculosis is polymorphic and nonspecific clinical expression. Diagnosis is difficult due to mimicry factors. The absence of HIV, clinical, radiological and histological polymorphism are the main misleading factors. Rapid and molecular detection tests could have an impact on the real prevalence of this pathology in the surgical and proctological specialty.