Zusammenfassung
Die Peritonealtuberkulose kann wegen der unspezifischen Symptome sogar für einen erfahrenen
Arzt eine diagnostische Herausforderung sein. Wir berichten über zwei Patientinnen,
die wegen therapierefraktärer, chronischer Unterbauchmerzen mit Gewichtsabnahme und
Ascites in unsere Klinik aufgenommen wurden. Die im Rahmen einer explorativen Laparotomie
bei Verdacht auf Peritonealkarzinose entnommenen PEs von der Beckenwand und Omentum
majus ergab bei der histopathologischen Untersuchung eine Peritonealtuberkulose. Beide
Patientinnen wurden nach der Diagnosestellung tuberkulostatisch mit Isoniazid, Rifampicin,
Pyrazinamid und Streptomycin behandelt und sind seitdem beschwerdefrei. Anhand dieser
zwei Fallberichte werden die Symptomatik, die Schwierigkeiten bei der Diagnosestellung
und die Therapie der Peritonealtuberkulose diskutiert.
Chronic abdominal pains caused by peritoneal tuberculosis - two case reports
Summary
The diagnosis of a peritoneal tuberculosis could be a demanding task for even an experienced
Physician, because of the unspecific symptoms. We report on two patients, who as a
result of therapy refractory chronic abdominal pains, weight loss and ascites were
admitted to our hospital. The excisional biopsy taken from the peritoneum and the
omentum major during an exploratory laparotomy resulted in the histopathologic diagnosis
of peritoneal tuberculosis being made. Both patients were given tuberculostatic therapy
with isoniazid, rifampicin, pyracinamide and streptomycin and both have since recovered.
The symptoms, the difficulties encountered in making the diagnosis and the therapy
of the peritonealtuberculosis are discussed using these two case reports.
Schlüsselwörter
Unterbauchschmerzen - Peritonealtuberkulose - explorative Laparotomie
Key words
Abdominal pains - peritoneal tuberculosis - explorative laparotomy
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