Tuberculous peritonitis--report of 30 cases and review of the literature

Abstract

In this retrospective study, clinical presentation of peritoneal tuberculosis in an area with a high prevalence of tuberculosis is discussed. Thirty cases diagnosed in an eight-year period are presented. The disease was 2.3 times more common in females. Eighty per cent of the patients were less than 40 years old. Excluding two cases of long duration (one year and three years), mean duration of the symptoms before admission was 2.3 months. Fever, abdominal pain, swelling and weight loss were the main symptoms. Ascites was clinically detected in 80 per cent of cases. Intermediate strength PPD tuberculin skin test was positive in 61 per cent of cases. In 57.7 per cent there was radiologic evidence of pleuropulmonary disease suggestive of tuberculosis. Fourteen of 15 ascitic fluids examined were exudative in nature with predominance of lymphocytes. In the majority of patients diagnosis was proven with laparotomy and laparoscopy (12 cases in each group). In the remainder, tissue for diagnosis was obtained through blind peritoneal needle biopsy, percutaneous biopsy of liver and peripheral lymph node biopsy (two cases with each method).