Tuberculosis in the Peritoneum: Not Too Rare After All

Peritoneal tuberculosis is rare with increased incidence rates in recent years. The absence of characteristic clinical features of the disease often makes its diagnosis difficult and elusive. We present the case of 61-year-old female with peritoneal tuberculosis. The patient suffered from abdominal pain for a period of 5 months prior to admission. The diagnosis was established on the basis of findings from an abdominal computed tomography scan, a chest radiograph and histopathological analysis of the laparoscopic resection of the two masses. The patient was discharged from hospital receiving a fourfold antituberculous treatment with isoniazid, rifampicin, pyrazinamide and ethambutol. A high index of suspicion and a combination of radiologic, endoscopic, microbiologic and histopathological examination achieves diagnostic accuracy and prevents clinical mismanagement.

[1]  B. Henning,et al.  Tuberculous peritonitis in a German patient with primary biliary cirrhosis: a case report , 2008, Journal of medical case reports.

[2]  P. McDonald,et al.  Intra‐abdominal and gastrointestinal tuberculosis , 2007, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[3]  Z. Abbas,et al.  Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians. , 2006, World journal of gastroenterology.

[4]  F. Sanai,et al.  Systematic review: tuberculous peritonitis – presenting features, diagnostic strategies and treatment , 2005, Alimentary pharmacology & therapeutics.

[5]  R. Jasmer,et al.  Update on the treatment of tuberculosis and latent tuberculosis infection. , 2005, JAMA.

[6]  S. Srivastava,et al.  1. An Uncommon Case of Zoophilia , 2005, Medicine, science, and the law.

[7]  A. Ojeda,et al.  Tuberculosis peritoneal e intestinal: una enfermedad ancestral que impone nuevos retos en la era tecnológica. Informe de un caso y revisión de la literatura , 2005 .

[8]  M. Harma,et al.  Diagnosis of abdominal tuberculosis: experience from 11 cases and review of the literature. , 2004, World journal of gastroenterology.

[9]  J. Gómez-Cerezo,et al.  Computed tomography findings of peritoneal tuberculosis: systematic review of seven patients diagnosed in 6 years (1996-2001). , 2004, Clinical imaging.

[10]  A. Malik,et al.  Ultrasound in abdominal tuberculosis , 2003, Abdominal Radiology.

[11]  K. Demır,et al.  Tuberculous peritonitis – reports of 26 cases, detailing diagnostic and therapeutic problems , 2001, European journal of gastroenterology & hepatology.

[12]  H. F. Flippin,et al.  REPORT OF SEVEN CASES , 1936 .

[13]  Efrén Flores-Álvarez,et al.  Peritoneal tuberculosis. Report of seven cases. , 2010, Cirugia y cirujanos.

[14]  E. Flores-Álvarez,et al.  Tuberculosis peritoneal. Informe de siete casos , 2010 .

[15]  A. González Ojeda,et al.  [Peritoneal and intestinal tuberculosis: an ancestral disease that poses new challenges in the technological era. Case report and review of the literature]. , 2005, Revista de gastroenterologia de Mexico.

[16]  C. Franco-Paredes,et al.  Tuberculosis of the pancreas: report of two cases and review of the literature. , 2002, The American journal of the medical sciences.

[17]  C. Nierhoff,et al.  [Abdominal tuberculosis]. , 2002, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[18]  S. Nijhawan,et al.  Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. , 1992, The American journal of gastroenterology.