ACUTE PERDURED ABDOME DUE TO POSSIBLE PERITONEAL TUBERCULOSIS: A CASE REPORT

• Autor(a) principal: Alves, Paola Sardenberg
• Data de Publicação: 2018
• Outros Autores: Simao, Antonio, Pessanha Baldi, Felipe Eulalio, Caus, Maria Luiza Colodet, Silott, Pedro Furlan, Nunes, Thais Rodrigues
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Científica da Faculdade de Medicina de Campos
• Texto Completo: https://www.fmc.br/ojs/index.php/RCFMC/article/view/173
• topic: tuberculose; pneumoperitônio; abdome agudo perfurado.; Tuberculosis; Pneumoperitoneum; Acute pierced abdomen.

Introduction: Tuberculosis is a parasitic, transmissible, growing infectious disease in underdeveloped countries. The main organ affected is the lung. However, it is known that among the extra pulmonary infections, abdominal surgery occurs in about 12% of the cases, with the peritoneum being the main focus. Objective: To describe a case of a bacillary patient with peritonitis undergoing exploratory laparotomy. Description: Male patient, 19 years old, inmate, with abdominal pain in colic in epigastric region of intense intensity, productive cough, fever and weight loss for 3 months. Hepatomegaly and ascites were also identified. Chest X-ray showed a pattern of miliary tuberculosis, associated with a positive sputum BAAR test. After hospital admission, the RHZE scheme was started. On the third day, without improvement of the picture, abdominal computed tomography with diagnosis of pneumoperitoneum was requested. He was then submitted to exploratory laparotomy, which revealed multiple and whitish nodular lesions suggestive of peritoneal tuberculosis. It was also identified perforation in the anterior wall of the stomach, performed gastrostomy and referred to the Intensive Care Unit for clinical support with total parenteral nutrition. On the third postoperative day, the patient died. Conclusion: Peritoneal tuberculosis is a rare condition with high morbidity and mortality, and the prognosis depends on early diagnosis and treatment. This pathology must always be remembered in patients who evolve with hepatosplenomegaly and ascites, especially if there is already a pre-existing pulmonary focus.