Peritonitis

Case contributed by Doaa Faris Jabaz
Diagnosis probable

Presentation

Abdominal pain and weight loss.

Patient Data

Age: 25 years
Gender: Male
ct
Coronal
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
Download
Info

Diffuse smooth enhancing thickening of the peritoneal reflections and micro-nodular greater omentum and mesentery, abdominopelvic fluid density non-loculated ascites of a moderate amount.

No terminal ileum or caecal wall thickening, hyperaemia, or stricture. No feature of intestinal obstruction, bowel perforation, fistulae, abscesses, and/or haemorrhage

Few inguinal and mesenteric lymph nodes all are moderately enhancing, non-enlarged, with no necrosis, matting, or calcification.

Case Discussion

The patient had undergone appendicectomy one month ago, and the caecal biopsy showed chronic inflammatory infiltrate with multinucleated giant cells, however, the IGRA test was negative and no further workup was done.

CT findings of peritonitis likely tuberculous (the tumour marker results were negative), however the histopathological/laboratory assessment of the fluid aspirate, omental biopsy (preferably ultrasound guided), and culture are required to confirm the presence of caseating granulomas and AFB before commencing treatment.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.