Unmasking the Masquerade: Navigating the Diagnostic Enigma of Abdominal TB Mimicking Endometriosis

Abdomen is the second most common site of Tuberculosis. The diagnostic challenge of abdominal tuberculosis (TB) masquerading as endometriosis arises due to overlapping symptoms and the non-specific nature of both conditions. Abdominal TB can affect various organs, including the peritoneum, leading to symptoms such as abdominal pain, pelvic pain, and menstrual irregularities-symptoms that are also associated with endometriosis. The presentation is therefore vague and non specific ,making its diagnosis difficult. Abdominal tuberculosis at any age can always present as endometriosis or peritoneal carcinomatosis or ovarian malignancy, ileocecal c and other conditions with elevated CA125 levels and hence poses a diagnostic challenge. Presenting an interesting case of a 23 year old ,married female who presented to the ER with acute abdomen. Patient gives history of treatment for endometriosis for the past three months, in light of her symptoms and investigations that she presented with. Patient was posted for diagnostic laparoscopy and was diagnosed as intra abdominal TB with tissue diagnosis. Patient then received ATT and underwent infertility evaluation. Hence Diagnostic laparoscopy with tissue diagnosis is gold standard for timely diagnosis and treatment of Abdominal TB. Hence such cases must be approached with caution and with all the differentials in mind for prompt treatment.