↓ Skip to main content

Peritoneal tuberculosis presenting with portal vein thrombosis and transudative Ascites - a diagnostic dilemma: case report

Overview of attention for article published in BMC Infectious Diseases, September 2015
Altmetric Badge

Mentioned by

twitter
1 tweeter

Citations

dimensions_citation
8 Dimensions

Readers on

mendeley
34 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Peritoneal tuberculosis presenting with portal vein thrombosis and transudative Ascites - a diagnostic dilemma: case report
Published in
BMC Infectious Diseases, September 2015
DOI 10.1186/s12879-015-1122-6
Pubmed ID
Authors

Ushani Mayurika Wariyapperuma, Champa Indrani Welikala Jayasundera

Abstract

Peritoneal tuberculosis is an important problem in regions of the world where tuberculosis is still prevalent (Chest 1991; 99:1134). Atypical presentations such as portal vein thrombosis can delay diagnosis or result in misdiagnosis (Gut 1990; 31:1130, Acta ClinBelg 2012; 67(2):137-9, J Cytol Histol 2014; 5:278, Digestive Diseases and Sciences 1991; 36(1):112-115). A high index of suspicion is required for the diagnosis of peritoneal tuberculosis, as the analysis of peritoneal fluid for tuberculous bacillus is often ineffective, and may increase mortality due to delayed diagnosis. (Clin Effect Dis 2002;35: 409-13) In light of new evidence, peritoneal biopsy through laparoscopy or laparotomy has emerged as the gold standard for diagnosis (Clin Effect Dis 2002; 35: 409-13). We report a case of a 35 year old Sri Lankan female employed in a Middle - Eastern country who presented with progressive abdominal distention and constitutional symptoms for four months duration. She had been investigated abroad and diagnosed with ascites with chronic portal vein thrombosis following which warfarin therapy had been commenced suspecting an underlying thrombophilia. Despite treatment her symptoms had worsened. Therefore she had decided to return to Sri Lanka for further evaluation. After ruling out inherited thrombophilic states and the antiphospholipid syndrome, further investigations revealed a transudative ascites and high inflammatory markers. The tuberculosis work up on peritoneal fluid was negative. Therefore, we proceeded with laparoscopy which showed multiple nodular deposits on abdominal wall, bowel and omentum and peritoneal biopsy revealed granulomatous inflammation with caseous type necrosis compatible with mycobacterium tuberculosis infection. This was confirmed by tuberculosis genome identification on the biopsy sample confirming a diagnosis of peritoneal tuberculosis with secondary portal vein thrombosis and cavernous formation due to local inflammation. The patient was started on anti-tuberculosis treatment and warfarin was discontinued, following which she made a remarkable recovery. Peritoneal tuberculosis can present with unusual manifestations such as portal vein thrombosis and transudative ascites causing a diagnostic dilemma. Ascitic fluid analysis is generally not diagnostic. Under such circumstances peritoneal biopsy should be performed as it has a good diagnostic yield and accuracy.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 6 18%
Researcher 5 15%
Student > Master 4 12%
Student > Doctoral Student 3 9%
Student > Postgraduate 2 6%
Other 7 21%
Unknown 7 21%
Readers by discipline Count As %
Medicine and Dentistry 15 44%
Pharmacology, Toxicology and Pharmaceutical Science 2 6%
Nursing and Health Professions 2 6%
Agricultural and Biological Sciences 1 3%
Biochemistry, Genetics and Molecular Biology 1 3%
Other 5 15%
Unknown 8 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 September 2015.
All research outputs
#4,743,854
of 6,420,027 outputs
Outputs from BMC Infectious Diseases
#2,209
of 2,988 outputs
Outputs of similar age
#138,183
of 201,200 outputs
Outputs of similar age from BMC Infectious Diseases
#135
of 165 outputs
Altmetric has tracked 6,420,027 research outputs across all sources so far. This one is in the 14th percentile – i.e., 14% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,988 research outputs from this source. They receive a mean Attention Score of 3.3. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 201,200 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 20th percentile – i.e., 20% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 165 others from the same source and published within six weeks on either side of this one. This one is in the 3rd percentile – i.e., 3% of its contemporaries scored the same or lower than it.