Peritoneal tuberculosis. Radiographic diagnosis

Area of Science:

• Infectious Diseases
• Radiology
• Gastroenterology

Background:

• Peritoneal tuberculosis (TB) is an extrapulmonary manifestation of Mycobacterium tuberculosis infection.
• HIV infection is a significant risk factor, increasing the likelihood of developing peritoneal TB.
• Accurate diagnosis is crucial and typically requires microbiological or histopathological confirmation alongside imaging.

Observation:

• Abdominal ultrasonography and CT scans are valuable for radiographic diagnosis of peritoneal TB.
• Typical imaging findings include diffuse peritoneal thickening, ascites, and enlarged lymph nodes with caseating granulomas.
• Elevated cancer antigen 125 (CA-125) levels can be observed in affected patients.

Findings:

• The study presents two cases of peritoneal tuberculosis.
• Patients exhibited ascites and nodular peritoneal thickening on diagnostic imaging.
• High CA-125 levels were noted in both cases, prompting further investigation.
• Ultrasound-guided peritoneal biopsy confirmed the diagnosis in both patients.

Implications:

• This highlights the importance of considering peritoneal TB in patients with ascites and peritoneal thickening, especially those with risk factors like HIV.
• Diagnostic imaging, while suggestive, requires histopathological confirmation for definitive diagnosis.
• Peritoneal biopsy, guided by ultrasound, is an effective method for confirming peritoneal tuberculosis.