A 23 year old female patient comes with the history of a painful mass in the abdomen.  She was previously operated upon for a similar mass one and a half years ago. At that time  a cyst was aspirated but she has no further details of the pathology. She had received anti tuberculous therapy for nine months postoperatively.

On examination she was pale, with a right supra-clavicular  scar from a draining sinus. There were no other nodes palpable. She did not have pedal edema or jaundice.
Abdominal exam revealed a retroperitoneal mass 10 by 15 cms in the left anterior lumbar region. It was tender and uniformly firm. There were no other masses palpable and there was no hepato-splemomegaly.

A CT scan of the abdomen revealed two cystic retroperitoneal masses in the abdomen separate from the bowel.

At surgery a large cyst filled with yellow purulent fluid was found. A smaller cyst, filled with  similar fluid, was found on the left side. The cysts were de-roofed and sent for pathology. The patient was started on category II anti-tuberculous medication.

Diagnosis:  Drug resistant Mesenteric tuberculosis.