Tuberculous peritonitis in children: Two case reports highlighting the important role of imaging

Abstract

Tuberculous peritonitis is an uncommon extrapulmonary form of Mycobacterium tuberculosis infection, frequently presenting with nonspecific and insidious symptoms. Diagnosis is therefore difficult, unsuspected, and often delayed, especially in the pediatric patient without an obvious history of exposure to the pathogen.This report presents a 9-year-old Hispanic girl and a 3-year-old African American boy presenting with nonspecific and insidious symptoms, such as abdominal pain, distention, and fever in whom computed tomography findings of peritoneal thickening and enhancement, high density ascites, lymphadenopathy, and bowel wall thickening acted as key components in establishing a final diagnosis of the condition. Computed tomography is an important clinical adjuvant in making this difficult diagnosis.

Living donor liver transplantation in a patient with cocoon abdomen – Anesthesia concerns!

“…Similarly, computed tomography scan can show a circumscribed cluster of small bowel loops. [ 6 7 ] Unfortunately, our patient did not have any of these findings preoperatively which could have lead to preoperative diagnosis of Sclerosing Encapsulating Peritonitis (SEP).…”

Pediatric Abdominal Tuberculosis in Singapore: A 10-Year Retrospective Series

“…These imaging studies can aid in detecting abdominal lymphadenopathy, ascites, bowel wall and omental thickening, as well as complications such as perforation or stricture formation. 3,6,10,12,13 A combination of antituberculous drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol) given either in a 6-or 9-month period has been shown to be effective in treating children with abdominal TB. 14 Relapse has been shown to be uncommon using these treatment regimens, and most children have complete cure of the condition at the end of treatment, which is also illustrated in our case series.…”

Tuberculosis pleural y peritoneal simultánea en adolescentes: informe de caso

“…It happens through pre-existing latent sources in this structure, due to previous hematogenous dissemination from a primary pulmonar source; from active pulmonary tuberculosis hematogenous dissemination, and rarely by contiguity from a abdominal organs or adjacent pelvic organs, vertebral column and pleura involvement, as described by this scientific article. 17,22 Clinical manifestation can be acute or chronic. and symptoms as: fever, paleness, pain and abdominal distention, swelling, anorexia, weight loss, weakness, sweats and bowel habit disorder is reported.…”

“…More than 90% of peritoneal tuberculosis has ascite at time of diagnosis, www.medigraphic.org.mx while the rest of patients present the wet and/or fibrotic one in advanced stages. 17,21,22 This pathology differential diagnosis is very broad, including other granulomatous diseases, such as sarcoidosis and systemic amyloidosis, besides other infectious processes and malignant affections as lymphoma, mesothelioma and peritoneal carcinomatosis. 17,18,20 This affection diagnosis methods are not always accessible and some demand a lot of time for results obtaining, including ascitic fluid analysis under cellularity features and biochemistry when present; biomarkers dosage such as ADA and IGRA in addition to bacteriological exam; besides peritoneal fragment anatomopathology and skin test.…”