Abdominal tuberculosis is a common form of extrapulmonary tuberculosis. Clinical manifestations and presentations are diverse depending on the organ involved within the abdominal cavity.
26-year-old female with a background history of human immunodeficiency virus (HIV) presented with multiple irreducible para-umbilical hernias as the primary presentation of abdominal tuberculosis. Emergency hernia repair surgery revealed features of abdominal TB that was confirmed on polymerase chain reaction and histopathology. The patient was initiated on anti-tuberculosis therapy and was in a stable condition upon discharge.
The uncommon presentation described is very rare with only one documented case of abdominal tuberculosis diagnosis with an umbilical hernia. Abdominal tuberculosis can present with a wide range of symptoms with a variety of imaging and invasive modalities available to confirm the diagnosis.
This case report is the second documented case of abdominal tuberculosis within a paraumbilical hernia. The case report highlights paucity within literature related to the histopathological diagnosis of hernial sacs within an endemic area of tuberculosis. Further research within hernia registries of the histopathological diagnosis of hernia sacs will be beneficial for surgeons in endemic areas of abdominal tuberculosis.

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