2018 Volume 38 Issue 6 Pages 1111-1116
Tuberculous peritonitis is a type of extrapulmonary tuberculosis that is fatal when in the advanced stages. Early diagnosis and treatment of tuberculous peritonitis are important for treatment success. We report herein on two cases of tuberculous peritonitis diagnosed with a laparoscopic biopsy. The first patient was a 70-year-old female who presented to our hospital with abdominal pain and vomiting. Computed tomography (CT) revealed the thickening of the small intestinal wall, which was diagnosed as ileus. Surgery was performed following conservative therapy. The second patient was an 80-year-old female who presented to our hospital with abdominal distension. CT revealed ascites and mesenteric fat stranding. In the ascites, an increase in adenosine deaminase levels was confirmed without any atypical cells. Tuberculous peritonitis was suspected, and surgery was performed for a definitive diagnosis. In both cases, numerous white millet seed-sized nodules were observed in the abdominal cavity, and tuberculous peritonitis was pathologically diagnosed by confirming epithelioid cell granuloma with peritoneal biopsies. The diagnosis of tuberculous peritonitis can be difficult due to its varied symptoms. A laparoscopic biopsy is minimally invasive and can be effective for the early diagnosis and treatment of tuberculous peritonitis, leading to favorable outcomes.