Ascite riche en protides survenant deux mois après un accouchement par césarienne : diagnostic par association du dosage de l’adénosine-désaminase et de l’imagerie

We report the case of a 38-year-old woman, born and raised in Congo, in France for 7 years, who developed ascites 2 months after delivery by C-section. Thrombopenia at 95,000 elements per millimeter cube was diagnosed during her pregnancy and her obstetrician initiated a treatment with corticosteroids. Analysis of the ascitic fluid showed a high concentration of proteins (55.7 g/l), with 2000 elements, 80% of which were lymphocytes, and very high levels of adenosine deaminase. Thoracoabdominal tomodensitometry revealed ascites, a multinodular spleen, and hyperemia of the peritoneum; but the liver and the lungs were normal and no adenoma was identified. Laparoscopy was not performed and the suspected diagnosis of peritoneal tuberculosis was confirmed by only one culture of ascitic fluid.