A case report of peritoneal tuberculosis diagnosed by laparoscopy in a low prevalence setting.

A case report of peritoneal tuberculosis diagnosed by laparoscopy in a low prevalence setting. Acta Chir Belg. 2019 Nov 18;:1-13 Authors: Van Slambrouck J, Vlasselaers J, Devos B Abstract Peritoneal tuberculosis is a rare extrapulmonary manifestation of tuberculosis. Considering the diagnosis of peritoneal tuberculosis in a low prevalence setting can be vital for the further clinical management in selected patients.In a young male with migration background, presenting with generalised abdominal pain, computed tomography revealed ascites, omental and peritoneal thickening and enlarged mesentery lymph nodes. Computed tomography also revealed a distal ureteral calculus at the right vesico-ureteral junction. Diagnostic laparoscopy showed a nodular degeneration of the visceral and parietal peritoneum and adhesions in the upper peritoneal cavity. Tissue biopsy of peritoneal lesions and omentum was performed. Histological examination revealed granulomas with central caseating necrosis. The ureteral stone was removed by means of ureteroscopy. Prompt diagnosis of peritoneal TB made possible to start anti-tuberculous chemotherapy without significant delay.The low prevalence of peritoneal TB demands a high index of suspicion in patients at risk presenting with nonspecific abdominal complaints, ascites and constitutional symptoms. Diagnostic laparoscopy leads to a quick diagnosis by direct visualisation of the peritoneal cavity and tissue biopsy...
Source: Acta Chirurgica Belgica - Category: Surgery Tags: Acta Chir Belg Source Type: research