A Case of Tuberculous Peritonitis Presenting as Small Bowel Obstruction

Abstract

The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation. An 85-year-old woman was referred our hospital for abdominal pain with ileus. Despite medical therapy, prolonged ileus and progression to sepsis were shown, she underwent surgery to confirm the diagnosis and relief of mechanical ileus. Intraoperative peritoneal biopsy and macroscopic findings confirmed tuberculous peritonitis. Therefore, physicians should consider the possibility of tuberculous peritonitis in patients with unexplained small bowel obstruction. (Korean J Gastroenterol 2017;69:308-311)

Report of two rare manifestations of abdominal tuberculosis mimicking neoplasia

“…The most frequent symptoms of a peritoneal infection are ascites and abdominal tension [ 3 , 4 , 8 ]. Mechanical ileus due to adherent small bowel loops or inflammation of the omentum majus is rare [ 4 , 9 , 10 ]. In pancreatic TB, epigastric pain and jaundice as a result of extrahepatic cholestasis are typical [ 5–7 ].…”

“…Regarding peritoneal TB, US may detect ascites or omental thickening and CT scans may reveal thickened small intestinal loops [ 2 , 8 , 10 ]; finally, laparoscopy can confirm the diagnosis [ 1 , 4 , 10 ]. In case of pancreatic involvement, specimens can be obtained both by CT and US-guided fine needle biopsy [ 5 , 6 ].…”

Spontaneous Resolution of Strangulated Small Bowel Obstruction in a Patient With Intestinal Tuberculosis After Starting Anti-tuberculosis Drugs: A Case Report

“…In this case, all of these findings were confirmed at the onset of treatment and were consistent with the clinical diagnosis of tuberculous peritonitis. Ultrasonography is useful in observing multiple fine septations, which are characteristically found in tuberculous peritonitis, while computed tomography can detect peritoneal, mesenteric, and omental involvement [12][13][14]. These imaging modalities are complementary.…”

Bowel obstruction due to tuberculosis band: A case report and review of the literature

“…The peritoneum is one of the most common external localizations of pulmonary tuberculosis, which poses a public health problem in endemic regions of the world, the frequency of which is accentuated by the increase in immunosuppressive therapy and the AIDS epidemic. Peritoneal tuberculosis represents 0.1-0.7% of all tuberculosis patients [1]; The incidence of intestinal obstruction due to tuberculosis ranges from 12% to 60% [2] we report the case of a 61-year-old patient with no particular pathological history who was admitted to the emergency room with a bowel obstruction syndrome which the surgical exploration found a bowel obstruction on a primary tuberculosis band . the work has been reported in line with the SCARE 2020 criteria [3].…”