Tuberculous peritonitis following intestinal perforation in malignancy

Area of Science:

• Gastroenterology and Hepatology
• Infectious Diseases
• Oncology

Background:

• Tuberculous peritonitis is a frequent cause of exudative ascites, particularly in younger individuals.
• It represents a significant form of extrapulmonary tuberculosis.
• Diagnosis is challenging due to a lack of specific clinical or imaging features, often leading to misdiagnosis, especially in elderly patients with concurrent malignancies.

Observation:

• This report details two cases of tuberculous peritonitis in elderly patients with existing malignancies, occurring post-intestinal perforation.
• The diagnosis was confirmed through laparoscopic peritoneal biopsy and Acid-Fast Bacilli (AFB) cultures of ascitic fluid.

Findings:

• Laparoscopic biopsy and AFB cultures are effective diagnostic methods for tuberculous peritonitis.
• Prompt initiation of anti-tuberculosis (anti-TB) medication is the standard treatment.

Implications:

• Highlights the importance of considering tuberculous peritonitis in elderly patients with ascites, especially those with malignancies and a history of intestinal perforation.
• Emphasizes the need for advanced diagnostic techniques like laparoscopy and microbiological cultures when standard methods are inconclusive.
• Underscores the treatability of tuberculous peritonitis with appropriate anti-TB therapy, even in complex cases.