Pelvic Tuberculosis

Abstract

Female patient, 20 years old. In December 2020, the patient presented with vague pain in the right lower abdomen for 3 days without obvious inducement and no fever, she underwent no treatment, and self-relieved. In February 2021, she went to a local clinic because of fever and chills. Physical examination showed right lower abdominal tenderness, and anti-inflammatory treatment was given for 3 days. The temperature improved, but there was still lower abdominal tenderness, and she underwent no further treatment. In March 2021, without obvious cause, she developed fever again (38.9 °C) accompanied by persistent lower abdominal and lumbar pain. She was hospitalized in another hospital (details unknown). Hematological examination: CA125: 761.7 U/mL; CA199: 18.47 U/mL; and HCG was normal. Ultrasonography showed bilateral adnexal masses, which adhered to each other and had unclear boundaries with uterus. For further treatment, she was hospitalized in our hospital in May and underwent laparoscopic examination, extensive intestinal adhesion decomposition, pelvic abscess incision and drainage, and peritoneal lesion biopsy. Intraoperative findings: the abdominal and pelvic cavity showed tuberculosis inflammatory miliary changes, normal anatomical structure disappeared, and ovaries and fallopian tubes showed tuberculous inflammatory destructive changes, containing a large amount of caseous tissue.