2015 Volume 40 Issue 6 Pages 1185-1188
A 67-year-old woman visited our hospital with the chief complaint of lower abdominal pain and pyrexia. Computed tomography (CT) revealed massive ascites and smooth uniform peritoneal thickening. The ascitic fluid was determined to have high levels of adenosine deaminase but bacteriological examination of the fluid showed no specific findings. Almost the entire peritoneal cavity showed high standardized uptake value on 18-fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT. Tuberculous peritonitis was strongly suspected, and a diagnostic laparoscopy and biopsy were performed to obtain an accurate diagnosis. The diagnosis of tuberculous peritonitis was confirmed by histopathological examination of biopsy specimens obtained from the tiny white nodules on the peritoneum. Early diagnosis of tuberculous peritonitis is important; however, accurate diagnosis is difficult from clinical findings and examination. We determined that FDG-PET/CT and exploratory laparoscopy are useful for obtaining an accurate diagnosis of tuberculous peritonitis.
