Tuberculous peritonitis - pediatric

Case contributed by Ian Bickle


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

Patient Data

Age: 8
Gender: Male


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.

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 pediatric 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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