Sonographic features of tuberculous peritonitis with female genital tract tuberculosis

Abstract

Our aim was to illustrate the sonographic features of tuberculous peritonitis with female genital tract tuberculosis in an attempt to facilitate the recognition of the disorder preoperatively. Transabdominal and transvaginal sonographic features and the findings from laparotomy/laparoscopy, endometrial biopsy and microbiology were reviewed and compared in 15 patients with tuberculous peritonitis with female genital tract tuberculosis. Of the 15 patients, 12 had wet tuberculosis and three had dry (adhesive) tuberculosis. Sonographic features of wet tuberculosis were categorized as follows: septated ascites (ten patients), particulate ascites (two patients), loculated fluid (two patients), thickened peritoneum (eight patients), thickened omentum (eight patients), adnexal mass (11 patients), adhesions (seven patients) and endometrial involvement (five patients). Adnexal masses, adhesions and loculated fluid were found to be present in the dry type. When sonographic findings were compared with those of laparotomy and/or laparoscopy and/or endometrial biopsy, ultrasound was able to identify aspects of tuberculosis infection as follows: ascites/loculated fluid, 13/13 (100%); adnexal mass, 12/13 (93%); peritoneal thickening, 9/13 (69%); omental thickening, 8/13 (61%); and endometrial involvement, 5/6 (83%). We conclude that awareness of the sonographic changes associated with tuberculosis infection may improve diagnostic accuracy, and avoid clinical mismanagement and surgical explorations in the wet type of tuberculosis.

Tuberculous Peritonitis With Sonographic Features of an Ovarian Cystadenoma

“…These include free or loculated intraabdominal fluid, intra-abdominal abscess formation, retroperitoneal lymph node enlargement, adnexal masses, endometrial involvement, adherent loops of bowel, and mesenteric and omental thickening. 7,8 None of the reported sonographic signs are diagnostic in isolation, but in the presence of clinical or microbiological suspicion, they may reduce the frequency of exploratory laparotomy. Ascitic fluid and sputum cultures yield positive results for mycobacterium in only 25% of tuberculosis cases.…”

Peritoneal tuberculosis: Diagnostic options

“…Her chest X-ray was also normal but 50% of patients with active tuberculous peritonitis have negative chest radiographs. Nonspecific signs of tuberculous peritonitis include anemia of chronic disease, elevated ESR, ascitic lactate dehydrogenase greater than 90 U/L, 5 ascitic lymphocytosis, complex ascites, 6 and elevated levels of CA 125. 7 The presence of these nonspecific signs (positive purified protein derivative skin test, elevated ESR, ascitic fluid lactate dehydrogenase level of 934 U/L, lymphocytic ascitic fluid, and complex ascites) favored the diagnosis of peritoneal tuberculosis prior to diagnostic laparoscopy.…”

Tuberculous Meningitis during Pregnancy in a Patient Treated for Infertility: A Case Report

“…Doku biyopsisi örneklerinde proliferatif granülomatöz lezyonla kalsifi kasyon nekrozu çev-resinde epitelyal dev hücre, periferik lenfositler, monositler ve fi broblastlardan oluşan konsantrik tabakaların yerleştiği gös-terilebilir. Genital tüberküloz tedavisinde standard antitüber-küloz tedaviler geçerlidir (11)(12)(13)(14)(15)(16)(17). Olgumuzda da olduğu gibi patolojik olarak anlamlı sonuçların gözden kaçırılması, hastanın daha ciddi klinik tablolarla karşımıza çıkmasına yol açabilir.…”

“…Genital tüberkülozun üç ana semptomu infertilite, pelvik ağrı ve menstrüel değişikliklerdir. En sık semptom %45-55 oranında görülen infertilitedir (11)(12)(13)(14)(15)(16)(17). Bu yazıda yedi yıldır infertilite nedeniyle izlenen hastada ikiz doğum sonrası gelişen tüber-külöz menenjit olgusu sunulmuştur.…”