PDF(Pubmed)
Abstract：
Portal vein thrombosis associated with peritoneal tuberculosis is an uncommon manifestation of extrapulmonary tuberculosis. We report one such case of a 33-year-old male with a one-year history of dyspepsia, having been on proton pump inhibitors all this time with temporary relief. In view of ongoing symptoms, an endoscopy was done, which at first showed duodenal ulcer. On repeat endoscopy after an interval, there was evidence of mucosa-associated lymphoid tissue (MALT) lymphoma, which prompted a host of investigations in the patient. A positron emission tomography (PET) scan revealed extensive omento-peritoneal involvement along with a hypodense lesion in the liver with interval development of portal vein thrombosis on a CT scan of the abdomen. The biopsy of the hepatic lesion showed granulomatous inflammation. Faced with a diagnostic dilemma, finally, a laparoscopic biopsy was done, which confirmed the diagnosis of peritoneal TB with portal vein thrombosis. This case highlights the importance of keeping a high index of suspicion to include tuberculosis as a differential when presented with a case such as this and to conduct appropriate investigations to establish the correct diagnosis.
摘要：
与腹膜结核相关的门静脉血栓形成是肺外结核的罕见表现。我们报告了一例有一年消化不良病史的33岁男性，一直服用质子泵抑制剂暂时缓解.鉴于持续的症状，做了内窥镜检查，最初显示十二指肠溃疡。间隔后重复内窥镜检查，有粘膜相关淋巴组织（MALT）淋巴瘤的证据，这促使对病人进行了大量的调查。正电子发射断层扫描（PET）扫描显示广泛的腹膜累及肝脏低密度病变，并在腹部CT扫描中出现门静脉血栓形成。肝病灶活检显示肉芽肿性炎症。面对诊断困境，最后,进行了腹腔镜活检，证实了腹膜结核合并门静脉血栓的诊断。该病例强调了在出现此类病例时保持高怀疑指数以包括结核病作为差异的重要性，并进行适当的调查以建立正确的诊断。
