■结核病在哥伦比亚是地方病,其肺形式在免疫活性宿主中的患病率很高,相反,腹膜受损是罕见且难以诊断的。
■一名住在农村地区的24岁女性患者出现体质和胃肠道症状到急诊科就诊,包括腹胀,腹泻,显著的体重减轻,夜间出汗,腹水逐渐发作并伴有腹痛。诊断检查,包括穿刺术,经阴道超声检查,腹部CT扫描,未提示恶性肿瘤或门脉高压。然而,诊断性腹腔镜检查显示,包括顶叶和盆腔腹膜,子宫,输卵管,大网膜提示腹膜结核。开始抗结核治疗,随后进行微生物学确认。
■结核病引起的腹部损害是一个诊断挑战,尤其是没有明显危险因素的患者。临床表现和临床旁数据可能没有特异性或不确定性,在明确确认之前需要腹膜活检和经验治疗。
UNASSIGNED: Tuberculosis is endemic in Colombia, the prevalence of its pulmonary form in immunocompetent hosts is high, and peritoneal compromise instead is rare and difficult to diagnose.
UNASSIGNED: A 24-year-old female patient living in a rural area presented to the emergency department with constitutional and gastrointestinal symptoms, including bloating, diarrhea, significant weight loss, nocturnal diaphoresis, and gradual onset of ascites with abdominal pain. Diagnostic workup, including paracentesis, a transvaginal ultrasound, and an abdominal CT scan, did not suggest malignancy or portal hypertension. However, diagnostic laparoscopy revealed a miliary pattern comprising the parietal and pelvic peritoneum, uterus, fallopian tubes, and major omentum suggestive of peritoneal tuberculosis. Anti-tuberculosis therapy was initiated with subsequent microbiological confirmation.
UNASSIGNED: Abdominal compromise by tuberculosis is a diagnostic challenge, especially in patients with no apparent risk factors. The clinical manifestations and paraclinical data may be unspecific or inconclusive, requiring peritoneal biopsy and empirical treatment before definitive confirmation.