Li C P, Hwang S J, Luo J C, Chang F Y, Lee S D, Chau G Y
Veterans General Hospital-Tapei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Adv Ther. 1998 Sep-Oct;15(5):271-6.
In geriatric patients with exudative ascites, malignant ascites is a common etiology. Tuberculous peritonitis is rarely seen and usually overlooked. We describe a 67-year-old man who suffered from exudative ascites for 1 month before admission. None of the noninvasive diagnostic methods utilized enabled us to make a correct diagnosis. Peritoneoscopic examination demonstrated multiple whitish miliary nodules and some larger nodules in the parietal and visceral peritoneum. Excisional biopsy confirmed the diagnosis of tuberculous peritonitis. This case reminds us that although malignant ascites is more prevalent in geriatric patients with exudative ascites, peritoneoscopy is indicated when noninvasive diagnostic methods allow no definite diagnosis.
在老年渗出性腹水患者中，恶性腹水是常见病因。结核性腹膜炎少见且常被忽视。我们描述一名67岁男性，入院前渗出性腹水已持续1个月。所采用的无创诊断方法均未能使我们做出正确诊断。腹腔镜检查显示壁层和脏层腹膜有多个白色粟粒样结节及一些较大结节。切除活检确诊为结核性腹膜炎。该病例提醒我们，尽管恶性腹水在老年渗出性腹水患者中更为常见，但当无创诊断方法无法明确诊断时，应进行腹腔镜检查。
