Abstract
About 1-5 % of cases of tuberculosis (TB) have uncommon abdominal conditions, and affect primarily young adults. The clinical diagnosis is challenging and often delayed due to the symptoms being non-specific and may be confused with other bowel diseases, therefore resulting in significant morbidity and mortality. A 27-year-old man was brought to our emergency department with the complaints a fever and abdominal pain. According to the chest X-ray findings taken 24 hours previously, pulmonary TB was suspected. Abdominal TB associated intestinal obstruction, ascites and lymphadenopathy were found by computed tomography and exploratory laparotomy. He was treated surgically by segmental resection, however passed away due to severe bleeding caused by the recurrence of perforation of the small intestine and sepsis. This case of systemic TB highlights the difficulties in diagnosis and treatment in time. The early diagnosis and timely treatment are both necessary to manage the disease successfully.