RESUMO
SUMMARY Tuberculous peritonitis is one of the most common causes of exudative ascites, especially in the young, and is an important cause of extra-pulmonary disease. However, tuberculous peritonitis is challenging to diagnose because there are no pathognomonic clinical features or imaging findings. Therefore, it is commonly misdiagnosed as another type of peritoneal disease, especially so in elderly patients with malignant disease. In this report, we described two cases of tuberculous peritonitis that were observed after intestinal perforation in elderly patients with malignancies. These diagnoses were established by laparoscopic peritoneal biopsy or AFB cultures of the ascitic fluid. Both patients were treated with anti-TB medications.
Assuntos
Humanos , Masculino , Idoso , Peritonite Tuberculosa/diagnóstico por imagem , Perfuração Intestinal/diagnóstico por imagem , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/diagnóstico por imagem , Peritônio/patologia , Peritônio/diagnóstico por imagem , Neoplasias Gástricas/patologia , Peritonite Tuberculosa/etiologia , Perfuração Intestinal/microbiologiaRESUMO
A tuberculose peritoneal é uma situação rara com alta morbidade e mortalidade, sendo que o prognóstico depende do diagnóstico e tratamento precoces. Nos últimos anos tem havido aumento de incidência nos países desenvolvidos, principalmente em pacientes imunocomprometidos. Foram analisados retrospectivamente 12 pacientes com tuberculose peritoneal (7 homens, média de idade: 51 anos). As manifestações clínicas, comorbidades e métodos diagnósticos foram revisados. Ascite foi a manifestação mais prevalente. Tuberculose pulmonar associada estava presente em apenas 25% dos pacientes. A biópsia de peritônio foi diagnóstica em todos os casos. Deve haver alto grau de suspeita para estabelecer o diagnóstico de TBC peritoneal (AU)
Peritoneal tuberculosis is a rare condition with high morbidity and mortality, and the prognosis depends of the early diagnosis and treatment. The incidence has been growing in the last years in developed countries, mainly in immunocompromised patients. Twelve patients with peritoneal tuberculosis were retrospectively studied (7 men, mean age 51 years). Data concerning to clinical manifestations, comorbidities and diagnostic methods were obtained. Ascites was the great manifestation. Pulmonar tuberculosis was associated in 25% of patients. Peritoneal biopsy was diagnostic in all patients. To make the diagnosis of peritoneal tuberculosis a high grade of suspicion is necessary (AU)