MALABSORPTION-SYNDROME COMPLICATING TUBERCULOUS PERITONITIS

A 22-year-old Nepali man presented with a 2-month history of fever, il l health, anorexia, loss of weight and diarrhoea. Apart from an ill-de fined lower abdominal mass, physical examination was unremarkable. Inv estigations showed the picture of malabsorption syndrome with no evide nce of structural gastro-intestinal tract involvement on barium meal, small bowel and large bowel enema, upper gastro-intestinal endoscopy, colonoscopy and mucous membrane biopsy. Laparoscopy showed typical fea tures of tuberculous peritonitis. Liver biopsy showed tuberculous gran ulomatous hepatitis, and peritoneal biopsy showed caseating granulomat a. The patient responded rapidly to antituberculosis chemotherapy.