High resistance index of Doppler ultrasound in tuberculous peritonitis presenting as abdominal carcinomatosis: report of two cases.
The radiologic features of tuberculous peritonitis (TB peritonitis) are seldom reported, and the use of color Doppler ultrasound in the diagnosis of TB peritonitis is even less common. Herein, we present two patients (a 29-year-old woman and a 56-year-old woman) who were evaluated for months of progressive enlargement of the abdomen, poor appetite and weight loss. In both patients, clinical and laboratory examinations suggested carcinoma, except a very high vascular resistance (resistance index 1.0 and 0.89, respectively) of the tumor feeding vessels detected by color Doppler ultrasound. TB peritonitis was finally diagnosed by exploratory laparotomy. Both patients were treated using a four-drug regimen of isoniazid, rifampicin, ethambutol hydrochloride and pyrazinamide for nine months and were clinically cured. In conclusion, if color Doppler ultrasound reveals normal ovaries, ascites containing thin, delicate incomplete or complete septa, and only a few high-resistance tumor feeding vessels in the abdominal cavity (resistance index > or = 0.80), TB peritonitis should be considered.
Wang
P H
PH
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, National Yang-Ming University School of Medicine, Taiwan, ROC.
Yuan
C C
CC
Yu
K J
KJ
Lee
R C
RC
Linn
J J
JJ
Hung
J H
JH
Chao
H T
HT
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color