Surgery Today

, Volume 30, Issue 5, pp 458–461

Tuberculous peritonitis defying diagnosis: Report of a case

  • Makoto Hasegawa
  • Nobuaki Wada
  • Hiroshi Yasuhara
  • Syuji Naka
  • Toshitaka Nagao
  • Yasuo Ishida
  • Isamu Sugano
  • Koichi Nagao
Case Reports

Abstract

A case of tuberculous peritonitis, which has beenscarcely encountered in clinical practice in recent years, is reported. A 32-year-old man was admitted to our hospital complaining of abdominal fullness, anorexia, and a 15kg weight loss. His abdomen was distended. There was neither any previous history nor recent contact with tuberculosis. The laboratory data indicated increased C-reactive protein and erythrocyte sedimentation rate, but the white blood cell count was normal. A chest X-ray examination revealed no abnormalities. abdominal X-ray showed scattered, small-intestinal gas shadows. Abdominal computed tomography scanning revealed a diffuse thickening of the dilated bowel wall, mainly adjacent to the mesentery. After a detailed examination a diagnosis of peritonitis carcinomatosa of unknown origin was suspected, and an exploratory laparotomy was done. Severe adhesions between the parietal peritoneum and the bowel were found. An excisional biopsy specimen was taken from the peritoneum, and a diagnosis of tuberculosis was thus made. Triple therapy with isoniazid, rifampicin, and kanamycin was started, and both the intestinal obstruction and anorexia were thus resolved.

Key Words

tuberculous peritonitis intestinal tuberculosis exploratory laparotomy 

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Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • Makoto Hasegawa
    • 1
  • Nobuaki Wada
    • 1
  • Hiroshi Yasuhara
    • 1
  • Syuji Naka
    • 1
  • Toshitaka Nagao
    • 2
  • Yasuo Ishida
    • 2
  • Isamu Sugano
    • 2
  • Koichi Nagao
    • 2
  1. 1.Department of Surgery, Ichihara HospitalTeikyo University School of MedicineIchihara-city, ChibaJapan
  2. 2.Department of Pathology, Ichihara HospitalTeikyo University School of MedicineIchihara-city, ChibaJapan

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