A Case of Tuberculous Peritonitis Diagnosed by Ultrasonography-Guide Peritoneal Biopsy

Mizunoe, Shunji; Morinaga, Ryotaro; Umeki, Kenji; Yamagata, Eiji; Hiramatsu, K; Yamakami, Yuriko; Yamasaki, Takahisa; Nagai, Hiromi; Murakami, Kojin; Kashima, Ken; Nasu, Masayoshi

doi:10.11150/kansenshogakuzasshi1970.74.589

Cited by 4 publications

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“…The most common USG and CT findings have been reported to be ascites, lymphadenopathy and thickness of mesenterium and peritoneum 4,7 . Abdominal USG and CT of the present patients revealed ascites with fine septations as the most common finding in 36 patients (92%), and thickening of peritoneum in 30 (77%).…”

Section: Discussionmentioning

confidence: 45%

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Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey

Tanrıkulu

Aldemir²,

Gürkan

et al. 2005

J of Gastro and Hepatol

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Abdominal tuberculosis (TB) is a rare manifestation, which can be overlooked on long-lasting and non-specific findings unless a high index of suspicion is maintained. The purpose of the present study was to investigate the diagnostic features of 39 patients hospitalized with tuberculous peritonitis (TBP) in Dicle University Hospital, Turkey between January 1994 and August 2003. Twenty-two patients were male; patient age ranged between 1 and 59 years (mean: 16.2 +/- 14.4 years). There were 21 patients (54%) under 15 years of age. Thirteen children had a history of familial TB and seven adults had prior history of TB. Six (29%) of 21 pediatric cases had bacille Calmette-Guerin (BCG) scars and results of 5-tuberculin units (TU) tuberculin test were positive in seven children (18%). Of all cases, the most common presenting findings were abdominal pain (95%), ascites (92%) and abdominal distention (82%). Five of the patients had accompanying pulmonary TB, and six patients (15%) had intestinal TB who were admitted to emergency service with acute abdomen, of whom three (8%) had perforation and three (8%) had ileus. Histopathologically 20 cases (51%) were proven on abdominal ultrasonography, and computed tomography revealed most commonly ascites and thickening of peritoneum. No microbiologic evidence was obtained except three positive culture results for Mycobacterium tuberculosis. As a result, TBP should be considered for diagnosis, in patients with non-specific symptoms of abdominal pain, wasting, fever, loss of appetite, abdominal distension and even symptoms of acute abdomen, because early diagnosis and effective treatment will decrease morbidity and mortality.

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Section: Discussionmentioning

confidence: 45%

“…Patients may present with non‐specific symptoms such as fever, abdomainal pain and weight loss. Infection is usually spread hematogenously and less frequently directly from other organs 2–6 …”

Section: Introductionmentioning

confidence: 99%

Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey

Tanrıkulu

Aldemir²,

Gürkan

et al. 2005

J of Gastro and Hepatol

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“…Polymerase chain reaction (PCR) for mycobacteria may prove helpful in obtaining results earlier (18) , but this technique has not yet attained widespread use. Another diagnostic approach may be cytopathological evaluation of ultrasonographically guided peritoneal biopsies (19) , although it was not practiced in the case of our 10 patients.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

Bilgin¹,

Karabay²,

Dolar

et al. 2001

Int J Gynecol Cancer

107

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Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 +/- 6.1 (median 37; range 18-72). Ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40-560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. Patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.

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Differential Diagnosis of Gynecologic Organ-Related Diseases in Women Presenting with Ascites

Cheng

Yen

Chao

et al. 2008

Taiwanese Journal of Obstetrics and Gynecology

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Ascites is a pathologic accumulation of fluid within the peritoneal cavity, and usually develops as a result of liver disease, congestive heart failure or nephrotic syndrome. Ascites is also a common manifestation of some gynecologic diseases. It is important that health care workers consider gynecologic problems among the potential differential diagnoses in patients presenting with ascites. Various kinds of ovarian diseases, such as epithelial ovarian cancer, benign ovarian fibroma, stromal hyperplasia, ovarian hyperstimulation syndrome, primary peritoneal serous carcinoma, endometriosis and peritoneal tuberculosis, should be kept in mind when women are found to have ascites.

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A Case of Tuberculous Peritonitis Diagnosed by Ultrasonography-Guide Peritoneal Biopsy

Cited by 4 publications

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Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey

Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey

Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

Differential Diagnosis of Gynecologic Organ-Related Diseases in Women Presenting with Ascites

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