Tuberculous abdominal cocoon mimicking peritoneal carcinomatosis

Zhi-Xin Meng†,
Yan Liu†,
Rui Wu,
Kai Shi and
Tao LiEmail author

†Contributed equally

Antimicrobial Resistance & Infection Control20198:108

https://doi.org/10.1186/s13756-019-0562-y

Received: 3 January 2019
Accepted: 14 June 2019
Published: 19 June 2019

Abstract

Background

Tuberculous abdominal cocoon is an uncommon manifestation of abdominal tuberculosis. As a rare clinical entity, it is often encountered unexpectedly in patients with small intestinal obstruction. Here we presented a rare case of tuberculous abdominal cocoon which was suspected to be peritoneal carcinomatosis and was finally diagnosed by laparoscopy.

Case presentation

A 47-year-old man developed small intestinal obstruction and massive ascites that did not resolve with conservative management. Surgical exploration revealed a fibrous sheath covering the small-bowel, and pathologic assessment of biopsies confirmed intra-abdominal tuberculous infection. After antituberculosis therapy, the ascites has greatly diminished and the patient was functioning normally.

Conclusion

Preoperative diagnosis of tuberculous abdominal cocoon is a true challenge. Early diagnostic peritoneal biopsy should be recommended and surgery is usually unnecessary if definitive diagnosis can be made.