| Theme | Advancement of Medical Practice for Peritonitis and Ascites | |
|---|---|---|
| Title | Tuberculous Peritonitis | |
| Publish Date | 2019/07 | |
| Author | Hirotoshi Fujikawa | Department of Gastroenterology and Hepatology, Endoscopy Center, Japan Community Health Care Organization Yokohama Central Hospital |
| Author | Shuhei Arima | Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine |
| Author | Akitake Uno | Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine |
| Author | Kenji Mimatsu | Department of Surgery, Japan Community Health Care Organization Yokohama Central Hospital |
| Author | Shunichi Matsuoka | Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine |
| Author | Mitsuhiko Moriyama | Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine |
| [ Summary ] | Although tuberculous peritonitis is a rare condition, it may be incidentally diagnosed in a patient undergoing examination for an acute abdomen or unknown fever and needs to be distinguished from gynecological malignancy in some patients. Isolation of Mycobacterium tuberculosis (through culture studies and/or the polymerase chain reaction test) from the ascitic fluid is necessary for the diagnosis of this condition, although the detection rate is low, and the serum adenosine deaminase level in ascitic fluid is a useful auxiliary diagnostic marker. Isolation of M. tuberculosis from ascitic fluid is the gold standard for diagnosis; however, macroscopic observation via laparoscopy, isolation of M. tuberculosis directly from the specimen, and histopathological examination are necessary for confirmatory diagnosis. Anti-tuberculosis drugs are used for treatment, and the serum cancer antigen 125 level is a useful index of treatment. Clinicians need to consider this condition in the differential diagnosis of suspected peritonitis in the clinical setting. | |