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Malabsorption syndrome complicating tuberculous peritonitis

I T Ramadan1, N U Abdul-Ghaffar

  • 1Medical Department, Adan Hospital, Kuwait.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|February 1, 1997
PubMed
Summary

Tuberculosis can affect the gastrointestinal tract, presenting as malabsorption syndrome. Early diagnosis and antituberculosis chemotherapy are crucial for effective treatment of tuberculous peritonitis.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Hepatology

Background:

  • Tuberculosis (TB) is a significant global health issue, with extrapulmonary manifestations posing diagnostic challenges.
  • Gastrointestinal tuberculosis (GITB) can mimic various gastrointestinal disorders, leading to delayed diagnosis.

Observation:

  • A 22-year-old man presented with a two-month history of fever, malaise, anorexia, weight loss, and diarrhea.
  • Physical examination revealed an ill-defined lower abdominal mass; initial investigations indicated malabsorption syndrome without structural gastrointestinal abnormalities.
  • Laparoscopy demonstrated features consistent with tuberculous peritonitis.

Findings:

  • Liver biopsy confirmed tuberculous granulomatous hepatitis.
  • Peritoneal biopsy revealed caseating granulomata, confirming tuberculosis.

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  • The patient showed a rapid clinical improvement following antituberculosis chemotherapy.

    • Implications:

    • This case highlights the importance of considering tuberculosis in the differential diagnosis of malabsorption syndrome, especially in endemic areas.
    • Laparoscopy and biopsy are essential for diagnosing gastrointestinal tuberculosis when conventional imaging is inconclusive.
    • Prompt initiation of antituberculosis therapy is critical for favorable outcomes in patients with gastrointestinal tuberculosis.