Postoperative granulomatous peritonitis mimicking abdominal tuberculosis

Kasper, Philipp; Pütz, Katharina; Fünger, Sarah Maria; Suárez, Isabelle; Jung, Norma; Alakus, Hakan; Bruns, Christiane; Rybniker, Jan

doi:10.1002/ccr3.1724

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…Although not depicted in this case, omental thickening and abdominal cocoon with matted small bowel are other classic laparoscopic findings for peritoneal TB [ 2 ]. Since granulomatous peritonitis and peritoneal TB share many identical clinical and histopathologic characteristics, postoperative granulomatous peritonitis remains a diagnosis of exclusion and the presence of Mycobacterium TB must first be excluded [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Sen

Brunton

Melchior

et al. 2020

Case Reports in Women's Health

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Peritoneal tuberculosis (TB) is a rare extrapulmonary manifestation of TB with non-specific clinical characteristics which can produce test results mimicking malignancy and granulomatous peritonitis. This case describes a Filipino 59-year-old, nulliparous woman who was admitted with abdominal pain, ascites, and an elevated CA-125 level. Radiographically, peritoneal nodules were visualized and initial suspicion was high for malignancy. Following a bilateral salpingo-oophorectomy and peritoneal biopsy, histology was negative for malignancy but revealed non-caseating granulomas. She was discharged then readmitted with progressive abdominal pain, and a repeat laparoscopic biopsy yielded specimens with growth of acid-fast bacilli (AFB). A delay in diagnosis and treatment of tuberculous peritonitis increases mortality rates, making early diagnosis with laparoscopic biopsy of paramount importance in prompt diagnosis and initiation of therapy. This patient was initiated on standard anti-TB therapy and experienced no complications.

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Section: Discussionmentioning

confidence: 99%

“…Abdominal tuberculosis (TB) is relatively rare [ 1 ]. One subtype of abdominal tuberculosis, peritoneal TB, is characterized by non-specific symptoms, laboratory tests, and imaging, making a high index of suspicion crucial for early diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Sen

Brunton

Melchior

et al. 2020

Case Reports in Women's Health

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“…The absence of specific clinical features and the limited sensitivity of diagnostic tests frequently contribute to difficulties in timely identification. Symptoms of abdominal TB, such as abdominal pain and distention, can mimic conditions such as Crohn's disease, postoperative granulomatous peritonitis, and other malignancies of the abdominal organs, complicating the diagnostic process [ 2 , 3 ]. Without a high degree of suspicion, a diagnosis can easily be missed or delayed.…”

Section: Introductionmentioning

confidence: 99%

Multi-Drug-Resistant Tuberculosis Peritonitis: A Case Report

Verma,

Sonier,

Rizvi

et al. 2024

Cureus

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The increasing incidence of tuberculosis raises concerns globally, impacting both developing and developed nations. Abdominal tuberculosis stands out as the most prevalent form of extrapulmonary tuberculosis. This case report details the diagnostic journey of a young male with abdominal TB complicated by concurrent HIV infection. The patient presented with night sweats and substantial weight loss, concurrently receiving a naive human immunodeficiency virus (HIV) diagnosis with an undetectable CD4 count. Imaging revealed abdominal lymphadenopathy concealing the pancreatic head while bronchoscopy unveiled TB in the lung. The patient faced septic shock and bilateral pulmonary embolism, possibly due to immune reconstitution inflammatory syndrome (IRIS). The patient then developed ascites, and a diagnosis of TB peritonitis was made based on low serum ascites albumin gradient (SAAG) and a positive acid-fast bacillus (AFB) result in the para-aortic lymph node. Treatment complexity arose from drug resistance to isoniazid and ethambutol.

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Benign peritoneal lesions: a brief review of selected entities

Mohamed¹,

Arora²

2023

Diagnostic Histopathology

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Postoperative granulomatous peritonitis mimicking abdominal tuberculosis

Cited by 8 publications

References 13 publications

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Multi-Drug-Resistant Tuberculosis Peritonitis: A Case Report

Benign peritoneal lesions: a brief review of selected entities

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