Peritoneal tuberculosis
case report
DOI:
https://doi.org/10.47456/rbps.v26isupl_3.12Keywords:
Peritoneal tuberculosis, Mycobacterium tuberculosis, Ascites, LaparoscopyAbstract
Introduction: Tuberculosis is an infectious, transmissible disease caused by the bacillus Mycobacterium tuberculosis, with the lungs being the most affected organ. Abdominal tuberculosis is the sixth most affected extrapulmonary site, affecting the gastrointestinal tract, peritoneum or mesenteric lymph nodes. Peritoneal tuberculosis affects both sexes and is related to low socioeconomic status, crowding and is associated with other comorbidities. It is an insidious disease. The main signs and symptoms are abdominal pain, ascites, weight loss and fever. Objective: To report a case of peritoneal tuberculosis, a rare and sometimes underdiagnosed disease, to assist health professionals in early diagnosis and treatment. Case report: A 60-year-old man, hypertensive and ex-smoker for 8 days, presented with diffuse abdominal pain and increased abdominal volume. Abdominal physical examination revealed mobile dullness. Diagnostic paracentesis revealed hypercellular ascitic fluid with a predominance of mononuclear cells, with a serum-ascites albumin gradient <1.1. Abdominal tomography showed small nodular thickenings with contrast enhancement scattered throughout the peritoneum. Diagnostic laparoscopy for peritoneal biopsy revealed multiple rice-grain nodules that were biopsied and histopathologically concluded as chronic granulomatous tuberculoid necrotizing inflammation. Conclusion: Peritoneal tuberculosis is a rare disease with subacute presentation and nonspecific symptoms. The gold standard for diagnosis is peritoneal biopsy, preferably by laparoscopy with subsequent histological or microbiological confirmation. The treatment of peritoneal tuberculosis does not differ from the treatment of pulmonary tuberculosis. Delayed diagnosis and treatment are one of the main factors of morbidity and mortality, therefore early diagnosis and treatment are important.
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