Abdominal Tuberculosis: Utility of Laparoscopy in the Correct Diagnosis

Muroni, Mirko; Rouet, Audrey; Brochériou, Isabelle; Houry, S

doi:10.1007/s11605-015-2753-z

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…Our findings further highlight the reported low sensitivity rates of acid-fast bacilli and Ziehl-Neelsen staining in detection of Tubercle bacilli in ascitic fluid [24][25][26], and the poor sensitivity and specificity of Gene expert in detection of abdominal TB from ascitic fluid samples [27]. The diagnosis of peritoneal tuberculosis in our case, like other related cases [17,18] was made through histological examination of intraoperative collected tissue samples, further stressing the need of pathological examination of samples as the gold standard for definitive diagnosis of peritoneal tuberculosis [28,29] Abdominal tuberculosis is generally responsive to medical treatment. Isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin are the five common first line medication for treatment of Tuberculosis with treatment duration consisting of a four-drug regimen administered for 2 months then continuation of treatment with rifampin and isoniazid for 4 or more months [30].…”

Section: Discussionmentioning

confidence: 65%

Extensive surgery for peritoneal tuberculosis, an ongoing diagnostic challenge in resource limited setup

Kiritta¹,

Mrisho²,

Mbulwa³

et al. 2021

J Clin Images Med Case Rep

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Background: Peritoneal Tuberculosis is an abdominal form of Tuberculosis that affects the peritoneal cavity and enclosed organs. Clinical presentation of this rare form of extrapulmonary tuberculosis resembles that of advanced ovarian cancer and may results in unnecessary extensive surgery especially in resource limited setting. Case presentation: A case of a 36 years old prisoner who presented to us with gradual onset of abdominal distension for one-month, mild abdominal pain and noticeable progressive weight loss. Physical examination revealed she was underweight, afebrile and had a healed sub umbilical median incision scar on a glossily distended abdomen with positive fluid thrill and shifting dullness. She was HIV negative, anemic and had marked elevation of Cancer Antigen 125 marker. Abdominal ultrasound scan showed ascites with multiple cysts originating from the left iliac fossa and the abdominal pelvic CT scan showing left ovarian cyst, ascites of 3 litres and diffuse peritoneal carcinomatosis. Advanced ovarian cancer was suspected and intra-operatively 2.5 liters of straw colored ascitic fluid was found, the bowels and the omentum were covered with diffuse intestinal nodules and multiple inclusion cysts occupying the pelvic cavity. Histopathological analysis of sampled tissues revealed Peritoneal Tuberculosis. Conclusion: Peritoneal tuberculosis shares similarities in presentation to advanced ovarian cancer and should be ruled out in a woman suspected of ovarian cancer before proceeding with surgery. For proper differentiation of the two, histopathological analysis of sampled tissue through frozen section biopsy is the preferred approach in resource limited setup where laparoscopic biopsy or ultrasound guided biopsy is not feasible.

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Section: Discussionmentioning

confidence: 65%

Extensive surgery for peritoneal tuberculosis, an ongoing diagnostic challenge in resource limited setup

Kiritta¹,

Mrisho²,

Mbulwa³

et al. 2021

J Clin Images Med Case Rep

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show abstract

“…Furthermore, laparoscopy with biopsies is helpful for correct diagnosis and appropriate management. 4 In developing countries, ultrasound is considered a potential public health benefit in terms of a more rapid diagnosis of TB. 5 In conclusion, this case report has the following characteristics:…”

Section: Discussionmentioning

confidence: 99%

Multiple surgical radical treatment in axillary lymph nodes: A case report

et al. 2019

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Lymph node tuberculosis is a common clinical bacterial infectious disease. Regional lymph node tuberculosis is often difficult to cure by surgically radical resection. In addition, its recurrence rate is higher, and it can easily cause lymphatic leakage. This case was considered to have left axillary lymph node tuberculosis. A combination of clinical examination, ultrasound, and magnetic resonance imaging examinations were performed before surgery. The surgical procedure performed was left axillary lymph node excision. Postoperative pathology confirmed the lymph node tuberculosis. The patient was given anti-tuberculosis drug treatment with no recurrence after 6 months follow-up. This provides new ideas and methods for the clinical treatment of regional lymph node tuberculosis.

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“…Therefore, diagnostic laparoscopy or laparotomy remained the best method in cases of diagnostic uncertainty and to obtain tissue sample for proper histopathological examination [ 12 , 15 ]. In the review of 20 cases by Xi et al, laparotomy was performed in 85% of patients with presumptive diagnosis of ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Abdominopelvic Tuberculosis Secondary to a Nontuberculous Mycobacterium in an Immunocompetent Patient

Yakob

et al. 2017

Case Reports in Medicine

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Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10–20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient. We report a case of NTM in abdominopelvic TB. A 37-year-old foreign worker, para 3, presented with a one-week history of suprapubic pain associated with fever. An assessment showed presence of a right adnexal mass. She was treated as tuboovarian abscess with intravenous antibiotics. Unfortunately, she did not respond. She underwent exploratory laparotomy. Intraoperatively, features of the mass were suggestive of a right mature cystic teratoma with presence of slough and cheesy materials all over the abdominal cavity as well as presence of ascites. Diagnosis of NTM was confirmed with PCR testing using the peritoneal fluid. This case was a diagnostic dilemma due to the nonspecific clinical presentation. Management of such rare infection was revisited.

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Abdominal Tuberculosis: Utility of Laparoscopy in the Correct Diagnosis

Abstract: In case of suspicion of tuberculosis, when bacteriologic and cytologic analysis is negative, laparoscopy with biopsies is helpful for correct diagnosis and appropriate management.

Cited by 12 publications

References 9 publications

Extensive surgery for peritoneal tuberculosis, an ongoing diagnostic challenge in resource limited setup

Extensive surgery for peritoneal tuberculosis, an ongoing diagnostic challenge in resource limited setup

Multiple surgical radical treatment in axillary lymph nodes: A case report

Abdominopelvic Tuberculosis Secondary to a Nontuberculous Mycobacterium in an Immunocompetent Patient

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