# Abdominal tuberculosis presenting as a massive lower GI bleed in a cerebral palsy patient—a case report

## TL;DR

A cerebral palsy patient with abdominal tuberculosis experienced a severe lower GI bleed, requiring emergency surgery after conservative treatments failed.

## Contribution

Highlights the diagnostic challenges of abdominal tuberculosis in non-verbal patients and its presentation as a massive lower GI bleed.

## Key findings

- Abdominal tuberculosis can present as a massive lower GI bleed in non-verbal patients.
- Conservative treatments like angioembolization may fail in such cases, necessitating emergency surgery.
- Diagnostic laparoscopy remains the most effective method for diagnosing abdominal TB.

## Abstract

Abdominal tuberculosis is a rare extrapulmonary manifestation of tuberculosis (TB), one that is increasingly encountered at hospitals serving a growing immigrant population. Since the COVID-19 pandemic, the incidence of TB has continually increased. The diagnostic differential often overlaps with inflammatory bowel disease, with diagnostic laparoscopy remaining the most effective modality of diagnosis. Additional diagnostic difficulties are encountered in patients unable to report symptoms. We present the case of a 52-year-old woman with cerebral palsy who presented initially with pulmonary symptoms and later developed massive lower gastrointestinal bleeding. Conservative management was attempted with angioembolization of a bleeding cecal mass on computed tomography. The patient initially improved and then decompensated after several hours. The patient then underwent emergent exploratory laparotomy for resection of a bleeding ileocecal mass which was found to be abdominal tuberculosis on pathology.