Peritoneal tuberculosis
DOI:
https://doi.org/10.24950/rspmi.984Keywords:
tuberculosis, peritoneal tuberculosis, intestinal obstructionAbstract
Peritoneal tuberculosis (TPe) is one of the rarest manifestations
of such infection. The diagnosis is often delayed because it is
seldom suspected, the clinical-laboratorial condition is nonspecific
leading to a poorer prognosis.
We report a case of a 59-year-old man, hospitalized for an
occlusive syndrome progressing for a week. The abdominal CT
scan showed bowel loops distention and a moderate volume
of ascites, retroperitoneal and mesenteric adenopathies and
peritoneal thickening. Then, the patient developed fever of
undetermined cause, refractory to multiple antibiotic schemes.
Colonoscopy, tumor markers, microbiology and serologies were
negative or normal. At the 55th day of hospitalization the patient
underwent exploratory laparotomy, defining a diagnosis of peritoneal tuberculosis.
In the majority of patients with TPe serum-ascites albumin
gradient is <1,1, with predominance of lymphocytes in the fluid.
The direct and cultural tests are positive at 2,5 and 20% of cases, respectively. The exploratory laparoscopy has sensitivity and
specificity of approximately 95% and should be performed early.
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