1/26. Richter's hernia: a rare presentation of abdominal tuberculosis.intestinal obstruction due to Richter's hernia has not been reported in abdominal tuberculosis. This 21-year-old man with abdominal tuberculosis presented with small gut obstruction due to Richter's hernia associated with ascites and patent right processus vaginalis (PV). He underwent laparotomy with reduction of Richter's hernia and closure of the PV at the right deep inguinal ring.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
2/26. endometriosis ascites: a case report.This is a case presentation of an usual nature, a 43-year-old Hispanic female, multigravida presenting with physical findings of massive ascites. In most instances, the presence of massive ascites is associated with malignancies, tuberculosis or perforated visous. In this case, the diagnosis of extensive endometriosis with ascites is reported as a very rare complication of the disease.- - - - - - - - - - ranking = 0.16666666666667keywords = tuberculosis (Clic here for more details about this article) |
3/26. A patient presenting with a pelvic mass, elevated CA-125, and fever.BACKGROUND: Tuberculous peritonitis is a rare event which can mimic advanced stage ovarian cancer. A pelvic mass and an elevated CA-125 is suggestive of an ovarian malignancy; however, benign conditions may be discovered, especially in the premenopausal patient. CASE: A patient with a pelvic mass, ascites, and an elevated CA-125 underwent an exploratory laparotomy for presumed ovarian cancer. Final pathology revealed pelvic tuberculosis without any pulmonary involvement. Acid-fast bacilli were confirmed with polymerase chain reaction in the surgical specimen. DISCUSSION: Pelvic tuberculosis is an uncommon gynecologic condition that presents with ascites, a pelvic mass, and fever. An elevated CA-125 is not specific for ovarian malignancy.- - - - - - - - - - ranking = 0.33333333333333keywords = tuberculosis (Clic here for more details about this article) |
4/26. Genital tuberculosis can present as disseminated ovarian carcinoma with ascites and raised Ca-125: a case report.In women with an adnexal mass, ascites and elevated Ca-125 levels, ovarian carcinoma must be ruled out. However, several other conditions, including genital tuberculosis, may present similarly. A 41-year-old woman with weight loss, ascites and elevated levels of Ca-125 was evaluated for ovarian cancer. Computerized tomography revealed an adnexal mass, ascites and lymph nodes on the peritoneal surface. paracentesis of the ascitic fluid revealed a lymphocytic exudate but failed to show any malignant cells. At laparotomy, frozen sections of tissue biopsies were negative for malignancy; however, a total hysterectomy plus adnexectomy was performed. Postoperatively histologic examination revealed typical features of genital tuberculosis. Antituberculosis treatment was effectively given to the patient. serum levels of Ca-125 were undetectable 12 weeks after treatment. In conclusion, genital tuberculosis can be misdiagnosed and confused with ovarian cancer. Intraperitoneal tuberculosis should be considered in the differential diagnosis in cases in which ovarian cancer is suspected, even when malignancy-associated risk factors are present.- - - - - - - - - - ranking = 1.5keywords = tuberculosis (Clic here for more details about this article) |
5/26. Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases.Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 /- 6.1 (median 37; range 18-72). ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40-560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.- - - - - - - - - - ranking = 1.1666666666667keywords = tuberculosis (Clic here for more details about this article) |
6/26. Pelvic tuberculosis mimicking signs of abdominopelvic malignancy.We discuss the clinical presentation and consequences of pelvic tuberculosis in the context of 3 cases having developed typical signs and symptoms of ascites and abdominal mass. These cases are reported to emphasize the difficulty of early diagnosis and treatment of the disease.- - - - - - - - - - ranking = 0.83333333333333keywords = tuberculosis (Clic here for more details about this article) |
7/26. Elevated serum cancer antigen 125 levels in advanced abdominal tuberculosis.A 48-yr-old female presented with a 1-yr history of pain in the hypochondrium and epigastrium. All routine investigations and computed tomography (CT) of the abdomen were done. CT findings revealed a well-defined cystic mass in the right ovary, and ascitis with features suggestive of secondaries over the omentum and peritoneal surface. The serum CA125 was 1255 U/mL (normal range 0-35 U/mL), which was indicative of ovarian malignancy. An exploratory laparotomy was performed. Histopathological examination of organs revealed the presence of granuloma. The patient was advised to undergo antitubercular treatment (ATT) and follow-up every month. After 1 mo of ATT, the CA125 level came down to 42 U/mL, which was near normal. As tuberculosis requires only a conservative management, we suggest that in cases of abdominopelvic mass with or without ascitis, high serum CA125 should always raise a suspicion of tuberculosis and a laparoscopy combined with peritoneal biopsy should be performed to confirm the diagnosis. This will prevent unnecessary laparotomies. Moreover, serum CA125 can be used to monitor the response of disease to antitubercular treatment.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
8/26. Peritoneal tuberculosis mimicking ovarian carcinoma with ascites and elevated serum CA-125: case report and review of literature.Peritoneal tuberculosis is rare in the western world, although its incidence has been increasing in recent years. The presenting signs and symptoms, imaging examinations and CA-125 status in peritoneal tuberculosis may resemble that of ovarian carcinoma. Thus, the possibility of peritoneal tuberculosis should be considered in the differential diagnosis of ovarian carcinoma, especially in women immigrants from countries with a high prevalence of tuberculosis. A case of peritoneal tuberculosis mimicking ovarian carcinoma in a young woman immigrant from india is described. The patient presented with ascites, abdominopelvic masses and elevated serum CA-125 (1,081 U/ml). laparoscopy confirmed the diagnosis of peritoneal tuberculosis and no malignancy, and thereby unnecessary extended surgery was avoided. Following treatment with the 4-drug anti-tuberculosis regimen, the patient recovered with disappearance of ascites and abdominopelvic masses, and return of CA-125 to normal range. It is concluded that laparoscopy, if feasible, seems to be a sufficient and safe method to provide diagnosis of peritoneal tuberculosis.- - - - - - - - - - ranking = 2keywords = tuberculosis (Clic here for more details about this article) |
9/26. The masquerades of female pelvic tuberculosis: case reports and review of literature on clinical presentations and diagnosis.In this review, tuberculosis of the genital tract was diagnosed retrospectively in 11 females over 15 years. The presentations of nine cases are described. Seven of the nine cases presented with ascites, vague abdominal distension, weight loss and were misdiagnosed as ovarian carcinoma. Eight women had no relevant past history. A review on clinical presentations and diagnosis of pelvic tuberculosis is presented. We conclude that although the incidence of tuberculosis is uncommon in developed countries, its prevalence appears to be increasing worldwide. Therefore, clinicians should consider tuberculosis as a differential diagnosis when encountering clinical presentations of pelvic mass and ascites.- - - - - - - - - - ranking = 1.3333333333333keywords = tuberculosis (Clic here for more details about this article) |
10/26. Peritoneal tuberculosis with negative polymerase chain reaction results: report of two cases.Peritoneal tuberculosis is rarely observed in European countries. We report on peritoneal tuberculosis in two female immigrants from somalia and Columbia who presented with diffuse abdominal pain, fever, weight loss and exudative, lymphocytic ascites. Laboratory investigations showed an increase in c-reactive protein and carcinoma antigen 125 serum levels. Nodular peritoneal lesions and adhesions were detected by ultrasound and computed tomography. In both patients, peritoneal biopsy from laparoscopy revealed epitheloid granulomas with central necrosis and multinucleate giant cells. microscopy and PCR analysis were, however, negative for mycobacterium tuberculosis in both patients. Despite repeated testing, ascites culture became positive for M. tuberculosis in only one patient. Shortly after starting antituberculous drug treatment, both patients improved, ascitic fluid disappeared and c-reactive protein and carcinoma antigen 125 serum levels returned to normal. Even in Western countries, peritoneal tuberculosis should be considered in any febrile patient with abdominal signs and symptoms, particularly if ascites is present. Empirical antituberculous treatment is justified in patients with clinical and histological features highly suggestive of peritoneal tuberculosis, even in cases with negative results from microscopy, culture and PCR analysis.- - - - - - - - - - ranking = 1.6666666666667keywords = tuberculosis (Clic here for more details about this article) |
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