Skip to main content

Tuberculous peritonitis defying diagnosis: Report of a case

Surgery Today volume 30, pages 458–461 (2000)Cite this article

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. O’Riordan DK, Deery A, Dorman A, Epstein OE (1995) Increased CA 125 in a patient with tuberculous peritonitis: case report and review of published works. Gut 36:303–305

    PubMed  Article  Google Scholar 

  2. Akinoglu A, Bilgin I (1988) Tuberculous enteritis and peritonitis. Can J Surg 31:55–58

    PubMed  CAS  Google Scholar 

  3. Jorge AD (1984) Peritoneal tuberculosis. Endoscopy 16:10–12

    PubMed  Article  CAS  Google Scholar 

  4. Denath FM (1990) Abdominal tuberculosis in children: CT findings. Gastrointest Radiol 15:303–306

    PubMed  Article  CAS  Google Scholar 

  5. Hulnick DH, Megibow AJ, Naidich DP, Hilton S, Cho KC, Balthazar EJ (1985) Abdominal tuberculosis: CT evaluation. Radiology 157:199–204

    PubMed  CAS  Google Scholar 

  6. Epstein BM, Mann JH (1982) CT of abdominal tuberculosis. AJR 139:861–866

    PubMed  CAS  Google Scholar 

  7. Dahlene DH Jr, Stanley RJ, Koehler RE, Shin MS, Tishler JMA (1984) Abdominal tuberculosis: CT findings. J Comput Assist Tomogr 8:443–445

    PubMed  Article  Google Scholar 

  8. Thoeni RF, Margulis AR (1979) Gastrointestinal tuberculosis. Semin Roentgenol 14:283–294

    PubMed  Article  CAS  Google Scholar 

  9. Zipser RD, Rau JE, Ricketts RR, Bevans LC (1976) Tuberculous pseudotumors of the liver. Am J Med 61:946–951

    PubMed  Article  CAS  Google Scholar 

  10. Kiu MC, Hsueh S, Ng SH, Chen JS (1994) Elevated serum CA-125 in tuberculous peritonitis: report of a case. J Formos Med Assoc 93:816–818

    PubMed  CAS  Google Scholar 

  11. Bergmann JF, Bidart JM, George M, Beaugrand M, Levy VG, Bohuon C (1987) Elevation of CA 125 in patients with benign and malignant ascites. Cancer 59:213–217

    PubMed  Article  CAS  Google Scholar 

  12. Bast RC Jr, Klug TL, John E St, Jenison E, Niloff JM, Lazarus H, Berkowitz RS, Leavitt T, Griffiths CT, Parker L, Zurawaki VR Jr, Knapp RC (1983) A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med 309:883–887

    PubMed  Article  Google Scholar 

  13. Khoury GA, Payne CR, Harvey DR (1978) Tuberculosis of the peritoneal cavity. Br J Surg 65:808–811

    PubMed  Article  CAS  Google Scholar 

  14. Singh MM, Bhargava AN, Jain KP (1969) Tuberculous peritonitis. An evaluation of pathogenetic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med 281:1091–1094

    PubMed  Article  CAS  Google Scholar 

  15. Martinez-Vazquez JM, Ocaña I, Ribera E, Segura RM, Pascual C (1986) Adenosine deaminase activity in the diagnosis of tuberculous peritonitis. Gut 27:1049–1053

    PubMed  Article  CAS  Google Scholar 

  16. Bañales JL, Pineda PR, Fitzgerald JM, Rubio H, Selman M, Salazar-Lezama M (1991) Adenosine deaminase in the diagnosis of tuberculous pleural effusions. A report of 218 patients and review of the literature. Chest 99:355–357

    PubMed  Article  Google Scholar 

  17. Marshall JB (1993) Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 88:989–999

    PubMed  CAS  Google Scholar 

  18. Frieden TR, Sterling T, Pablos-Mendez A, Kilburn JO, Cauthen GM, Dooley SW (1993) The emergence of drug-resistant tuberculosis in New York City. N Engl J Med 328:521–526

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Ichihara Hospital, Teikyo University School of Medicine, 3426-3 Anesaki, 299-0111, Ichihara-city, Chiba, Japan

    Makoto Hasegawa, Nobuaki Wada, Hiroshi Yasuhara & Syuji Naka

  2. Department of Pathology, Ichihara Hospital, Teikyo University School of Medicine, 3426-3 Anesaki, 299-0111, Ichihara-city, Chiba, Japan

    Toshitaka Nagao, Yasuo Ishida, Isamu Sugano & Koichi Nagao

Authors
  1. Makoto Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuaki Wada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroshi Yasuhara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Syuji Naka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshitaka Nagao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuo Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Isamu Sugano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Koichi Nagao
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hasegawa, M., Wada, N., Yasuhara, H. et al. Tuberculous peritonitis defying diagnosis: Report of a case. Surg Today 30, 458–461 (2000). https://doi.org/10.1007/s005950050625

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s005950050625

Key Words

  • tuberculous peritonitis
  • intestinal tuberculosis
  • exploratory laparotomy