腹腔鏡下生検が診断に有用であった結核性腹膜炎の1例

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  • A CASE OF BENEFICIAL USE OF LAPAROSCOPIC BIOPSY FOR THE DIAGNOSIS OF TUBERCULOUS PERITONITIS

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A 70-year-old man was admitted our hospital with right flank pain and ascites. Tuberculous peritonitis was suspected, because of the high ADA level of ascites. For an accuratediagnosis, laparoscopy was performed. A laparoscopic examination showed some tiny white nodules in the peritoneum. Biopsy specimens of peritoneum revealed epithelioid cellgranulomas and Langhans'giant cells. Laparoscopic examination was useful for the clinicaldiagnosis of tuberculous peritonitis. Recently, the incidence of tuberculous peritonitis has beendecreasing since the introduction of effective chemotherapy against Mycobacterium Tuberculosis. The diagnosis of tuberculous peritonitis is quite difficult because the symptoms are notspecific for the disease and the incidence of occurrence are relatively rare. We report a caseof tuberculous peritonitis with a review of 72 cases of tuberculous peritonitis seen in theJapanese literature.

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