Presentation
Abdominal distension with a low grade fever. The ultasound revealed massive ascites. The upper GI endoscopy and colonoscopy were normal. An MR enterography was requested.
Patient Data
Massive ascites with regular and nodular thickening with enhancement of the peritoneal reflections. Thickening with ‘cake-like omentum. Uniform reactive thickening with enhancement of the small bowel wall with no evidence of soft mass or luminal narrowing. No mass or abnormal thickening of the ileocecal region. No intra-or retroperitoneal lymphadenopathy.
Case Discussion
The MRI features in correlation with the clinical presentation and normal upper GI endoscopy and colonoscopy should suggest much more the diagnosis of peritoneal tuberculosis than peritoneal carcinomatosis.
The patient underwent a guided-ultrasound biopsy of the greater omentum that confirm the diagnosis of peritoneal tuberculosis.