A Case of Tuberculous Peritonitis Complicating Early Gastric Cancer Diagnosed by Exploratory Laparoscopy

Abstract

The patient was a 75-year-old woman who was admitted to our hospital with a history of fever, malaise, and anorexia. Findings of abdominal computed tomography led to the suspicion of carcinomatous peritonitis. Upper gastrointestinal endoscopy revealed an ulcerative lesion in the stomach with suspected submucosal invasion. The T-SPOT.TB examination was positive. However, TB-PCR of ascites fluid was negative and ascitic fluid cytology was Class Ⅱ, with no evidence of malignancy. Therefore, an exploratory laparoscopy was performed, and peritoneal biopsy revealed the diagnosis of tuberculous peritonitis. We performed distal gastrectomy for the gastric cancer after completion of anti-tuberculous therapy. The exploratory laparoscopy proved useful for the diagnosis of tuberculous peritonitis.