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Image of the Month—Quiz Case
Cheng-Maw Ho, MD;
Po-Huang Lee, MD, PhD
Arch Surg. 2007;142(12):1219.
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INTRODUCTION
A 39-year-old man with alcoholism for 20 years complained of fever, intermittent diffuse abdominal pain, and progressive abdominal distention for 2 weeks. Results of physical examination and abdominal sonography revealed ascites without jaundice. Results of acid-fast staining and polymerase chain reaction of the aspirated ascitic fluid, with numerous lymphocytes, were negative for any bacilli or Mycobacterium tuberculosis. Abdominal magnetic resonance imaging showed septate fluid-containing cavities and thickened peritoneum (Figure 1). Laparotomy revealed violin string–like fibrinous strands, white miliary nodules, and omental thickening (Figure 2).
Figure appears in full text version.
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Figure 1. Abdominal magnetic resonance image shows lobulated ascites and thickened peritoneum.
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Figure 2. Laparotomy reveals violin string–like fibrinous strands, white military nodules, and omental thickening.
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What Is the Diagnosis?
A. Carcinomatosis peritonei
B. Sarcoidosis
C. Tuberculous peritonitis
D. Starch peritonitis
Answer
Author Affiliation: Department of Surgery, National Taiwan University Hospital, Taipei.
SECTION EDITOR: GRACE S. ROZYCKI, MD
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Image of the Month—Diagnosis
Arch Surg. 2007;142(12):1220.
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