Tuberculous peritonitis - paediatric

Case contributed by Dr Ian Bickle

Presentation

8 year-old boy with abdominal distension and scrotal swelling. Presumed testicular malignancy.

Patient Data

Age: 8
Gender: Male

ULTRASOUND REPORT

Moderate moderate volume ascites measuring up to 3 cm in depth. The ascites has internal echoes.

Solid organs normal.

CT abdomen

Moderate volume ascites. The ascites tracks into the left hemiscrotum.

Multiple peritoneal nodules measuring up to 2 cm.

Several of the peritoneal nodules are studded on to the serosal surface of the lateral aspect of the bladder bilaterally.

Solid organs of the upper abdomen normal.

Mesenteric lymph adenopathy. Bilateral inguinal lymph nodes measuring up to 8 mm.
 

Photo

Surgical biopsy of the peritoneum was undertaken

Surgical biopsy of the peritoneum.

Case Discussion

A case to catch the unsuspected.   All clinical assumption initially on this being a paediatric malignancy and peritoneal nodules to fit with this on the CT.

Often these patients have no fever and weight loss, which also tends towards a malignant process.

The child underwent surgical excision of one of the peritoneal nodules.   The thickened inflammed peritoneum prevented diagnostic laproscopy.

Later during admission it is established the mother received TB treatment 1 year prior.

TB - the great multisystem mimicker.

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Case information

rID: 47440
Case created: 16th Aug 2016
Last edited: 21st Mar 2017
Inclusion in quiz mode: Included

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