A 66-year-old previously healthy woman presented to hospital with 1 month of malaise, abdominal swelling and early satiety. She had immigrated from the Philippines 40 years before and had previous exposure to tuberculosis (TB) and a positive interferon-γ release assay. Examination using abdominal computed tomography found ascites and omental nodularity.
诊断可肠术显示淋巴细胞 - 促腹水腹水低，血清contrum-ascites白蛋白梯度低，对恶性细胞阴性。染色为酸性杆菌阴性，培养结果对分枝杆菌阴性。我们进行了诊断性腹腔镜检查，表明患者的顶胸膜和内脏腹膜与腹膜结核一致（图1一个）。腹膜活检样品表现出非灾作用的肉芽瘤，对泛敏感性培养阳性结核分枝杆菌complex (图1 b) although negative for organisms. After treatment with appropriate antibiotics, the patient’s clinical condition improved. We reported the case to the public health office for contact tracing.
一名66岁妇女患有腹膜结核病的腹腔镜发现。（a）照片显示顶叶上的白色结核矿床（白箭头）。（b）腹膜活检样品的显微镜，显示了许多非核肉芽肿（红色箭头）。苏木精灵藏红花染色。原始放大倍×100。
The incidence of active TB infection in Canada is 4.9/100 000.1Risk factors for infection include immunosuppression, contact with known or suspected cases, travel to or immigration from endemic countries, or living in communities with a high prevalence of TB.1Eighty percent of people with TB have pulmonary involvement; isolated peritoneal TB occurs in only 1% of cases.2,3诊断是具有挑战性的，因为腹腔液的酸性杆菌染色和分枝杆菌培养物的敏感性分别低至3％或更少和20％或更少。4–6Mycobacterial culture from peritoneal biopsy is the diagnostic gold standard. In conjunction with histology, laparoscopic examination has sensitivities and specificities greater than 90%.5腹膜结核病should be considered in the differential diagnosis of ascites with a low serum-ascites albumin gradient with lymphocytosis in patients with risk factors or known latent infection.
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