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Tuberculous peritonitis complicated by an intraperitoneal tuberculous abscess: A case report
Wei-Peng Liu1, Feng-Zhen Ma2, Zhou Zhao1
1Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China.
Background:
Tuberculous peritonitis (TBP) is a chronic, diffuse inflammation of the peritoneum caused by Mycobacterium tuberculosis. The route of infection can be by direct spread of intraperitoneal tuberculosis (TB) or by hematogenous dissemination. The former is more common, such as intestinal TB, mesenteric lymphatic TB, fallopian tube TB, etc., and can be the direct primary lesion of the disease.
Case Summary:
We present an older male patient with TBP complicated by an abdominal mass. The patient's preoperative symptoms, signs and imaging data suggested a possible abdominal tumor. After surgical treatment, the patient's primary diagnosis of TBP complicating an intraperitoneal tuberculous abscess was established by combining past medical history, postoperative pathology, and positive results of TB-related laboratory tests. The patient's symptoms were significantly reduced after surgical treatment, and he was discharged from the hospital with instructions to continue treatment at a TB specialist hospital and to undergo anti-TB treatment if necessary.
Conclusion:
This case report analyses the management of TBP complicated by intraperitoneal tuberculous abscess and highlights the importance of early definitive diagnosis in the hope of improving the clinical management of this type of disease.
Insights
Tuberculous peritonitis (TBP) can present as an abdominal mass, mimicking cancer. Early diagnosis and surgical treatment are crucial for managing TBP with tuberculous abscesses.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Oncology
Background:
- Tuberculous peritonitis (TBP) is a diffuse peritoneal inflammation caused by Mycobacterium tuberculosis.
- Infection typically spreads directly from other tuberculous sites, such as intestinal or lymphatic tuberculosis.
- Hematogenous dissemination is a less common route of infection.
Observation:
- An elderly male patient presented with symptoms suggestive of an abdominal tumor.
- Preoperative imaging and clinical signs indicated a possible malignancy.
- The patient was treated surgically for what was initially presumed to be an abdominal tumor.
Findings:
- Postoperative pathology confirmed tuberculous peritonitis complicated by an intraperitoneal tuberculous abscess.
- Diagnosis was supported by patient history and positive TB-specific laboratory tests.
- The patient experienced significant symptom improvement after surgical intervention.
Implications:
- This case underscores the challenge of differentiating TBP with abscess from abdominal malignancies.
- Early and accurate diagnosis is vital for effective management of tuberculous peritonitis.
- Prompt surgical treatment followed by anti-TB therapy can lead to favorable outcomes.
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