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[Abdominal pseudotumor and Whipple's disease]
M Guilera1, E Rodríguez de Castro, J Solé
1Servicio de Medicina Interna, Hospital Virgen de Monte Toro, Maó, Menorca.
Gastroenterologia Y Hepatologia
|May 1, 1996
Summary
Whipple's disease, a rare systemic illness, can present with unusual symptoms like fever and abdominal masses. Diagnosis often requires invasive procedures like exploratory laparotomy and biopsy for confirmation.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Internal Medicine
Background:
- Whipple's disease is a rare, chronic, systemic infectious disease caused by Tropheryma whipplei.
- It primarily affects the gastrointestinal tract but can involve multiple organ systems.
Observation:
- A woman presented with weight loss, fever of unknown origin, skin eruptions, and abdominal distension.
- Ascitic fluid analysis revealed E. coli infection, suggesting spontaneous bacterial peritonitis secondary to chronic liver disease.
Findings:
- Abdominal exploration identified a mesogastric mass.
- Echographic and tomographic imaging failed to determine the mass's origin.
- Exploratory laparotomy and biopsy were crucial for the final diagnosis of Whipple's disease.
Implications:
- This case highlights the diagnostic challenges posed by atypical presentations of Whipple's disease.
- It underscores the importance of considering rare conditions in patients with unexplained symptoms.
- Advanced imaging and surgical exploration remain vital for diagnosing uncommon gastrointestinal disorders.