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Miliary Tuberculous Peritonitis
May 2003, Vol. 10, No. 2
The Journal of the American Association of Gynecologic Laparoscopists
Images in Endoscopy
Miliary Tuberculous Peritonitis Athanasios Protopapas, M.D., and Spyros D. Milingos, M.D.
FIGURE 1. Unexplained pyrexical ascites in a postmenopausal women, in whom the diagnosis of miliary peritoneal tuberculosis was confirmed by biopsy tissues obtained at laparoscopy. Note disseminated spread of whitish tuberculosis deposits. Top left: anterior abdominal wall peritoneum. Top right: milia and free fluid in right subdiaphragmatic space. Bottom left: confluent lesions in pelvic peritoneum. Bottom right: laparoscopic biopsy specimen from pouch of Douglas. (J Am Assoc Gynecol Laparosc 10(2):139, 2003)
Primary peritoneal tuberculosis is a rare disease and is usually associated with ascites and elevated CA 125 levels, mimicking advanced ovarian cancer. Preoperative diagnosis can be extremely difficult, because acid-fast stains and special cultures of ascitic fluid
for Mycobacterium tuberculosis are frequently negative. Confirmation of the diagnosis commonly requires histologic examination of biopsy specimens, in which epithelioid granulomas with central caseous necrosis can be identified.
From the 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Maternity Hospital, Athens, Greece. Submitted November 13, 2002. Accepted for publication December 3, 2002. Reprinted from the JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS, May 2003, Vol. 10 No. 2 © 2003 The American Association of Gynecologic Laparoscopists. All rights reserved. This work may not be reproduced in any form or by any means without written permission from the AAGL. This includes but is not limited to, the posting of electronic files on the Internet, transferring electronic files to other persons, distributing printed output, and photocopying. To order multiple reprints of an individual article or request authorization to make photocopies, please contact the AAGL.
139
The Journal of the American Association of Gynecologic Laparoscopists
Images in Endoscopy
Miliary Tuberculous Peritonitis Athanasios Protopapas, M.D., and Spyros D. Milingos, M.D.
FIGURE 1. Unexplained pyrexical ascites in a postmenopausal women, in whom the diagnosis of miliary peritoneal tuberculosis was confirmed by biopsy tissues obtained at laparoscopy. Note disseminated spread of whitish tuberculosis deposits. Top left: anterior abdominal wall peritoneum. Top right: milia and free fluid in right subdiaphragmatic space. Bottom left: confluent lesions in pelvic peritoneum. Bottom right: laparoscopic biopsy specimen from pouch of Douglas. (J Am Assoc Gynecol Laparosc 10(2):139, 2003)
Primary peritoneal tuberculosis is a rare disease and is usually associated with ascites and elevated CA 125 levels, mimicking advanced ovarian cancer. Preoperative diagnosis can be extremely difficult, because acid-fast stains and special cultures of ascitic fluid
for Mycobacterium tuberculosis are frequently negative. Confirmation of the diagnosis commonly requires histologic examination of biopsy specimens, in which epithelioid granulomas with central caseous necrosis can be identified.
From the 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Maternity Hospital, Athens, Greece. Submitted November 13, 2002. Accepted for publication December 3, 2002. Reprinted from the JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS, May 2003, Vol. 10 No. 2 © 2003 The American Association of Gynecologic Laparoscopists. All rights reserved. This work may not be reproduced in any form or by any means without written permission from the AAGL. This includes but is not limited to, the posting of electronic files on the Internet, transferring electronic files to other persons, distributing printed output, and photocopying. To order multiple reprints of an individual article or request authorization to make photocopies, please contact the AAGL.
139