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Tuberculous peritonitis in a geriatric patient: a case report
1Veterans General Hospital-Tapei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Abstract:
In geriatric patients with exudative ascites, malignant ascites is a common etiology. Tuberculous peritonitis is rarely seen and usually overlooked. We describe a 67-year-old man who suffered from exudative ascites for 1 month before admission. None of the noninvasive diagnostic methods utilized enabled us to make a correct diagnosis. Peritoneoscopic examination demonstrated multiple whitish miliary nodules and some larger nodules in the parietal and visceral peritoneum. Excisional biopsy confirmed the diagnosis of tuberculous peritonitis. This case reminds us that although malignant ascites is more prevalent in geriatric patients with exudative ascites, peritoneoscopy is indicated when noninvasive diagnostic methods allow no definite diagnosis.
Insights
Tuberculous peritonitis is often overlooked in elderly patients with exudative ascites. Peritoneoscopy is crucial for diagnosing this rare condition when other methods fail.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Geriatric Medicine
Background:
- Malignant ascites is a common cause of exudative ascites in geriatric patients.
- Tuberculous peritonitis is a rare but serious differential diagnosis that is often overlooked.
Observation:
- A 67-year-old male presented with a month of exudative ascites.
- Noninvasive diagnostic methods were insufficient to establish a diagnosis.
- Peritoneoscopy revealed miliary and larger nodules on the peritoneum.
Findings:
- Excisional biopsy confirmed tuberculous peritonitis.
- This case highlights the diagnostic challenges of tuberculous peritonitis in the elderly.
Implications:
- Peritoneoscopy should be considered in geriatric patients with unexplained exudative ascites.
- Early diagnosis of tuberculous peritonitis is essential for appropriate management.
- This underscores the importance of considering rare etiologies in geriatric ascites.