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Published on: November 11, 2011
Pooled analysis of 163 published tuberculous peritonitis cases from Turkey
Abstract:
Background/aim: Tuberculous peritonitis may be difficult to diagnose due to its insidious and variable clinical manifestations as well as characteristics similar to malignancy. In this study, case reports from Turkey over the last 10 years were reviewed systematically using pooled analysis. Materials and methods: Thirty-four suitable articles were found and 163 tuberculous peritonitis cases were included in the study. Results: The mean age was 34.1 years (17–79 years), and 146 (98.6%) of the patients were female and 17 (10.4%) were male. The most common complaints of these patients were abdominal pain (77.4%) and abdominal distention (73.5%). Ascites in the abdomen (75%), fever (42%), abdominal tenderness (33%), and abdominal distention (30.7%) were the most common physical examination findings. The mean adenosine deaminase level was 120.3 IU/L. In the subsets of patients with relevant data, acid-fast bacilli were found in 23.3%, culture was positive in 22.2%, and Mycobacterium tuberculosis polymerase chain reaction was positive in 20%. In abdominal imaging, ascites was reported in 92%. Elevated serum CA-125 was reported in 96.7% of the patients. Of 105 patients with data available following the antituberculous therapy prognosis, four (3.8%) died and the other 101 (96.2%) showed good treatment response. Conclusion: Tuberculous peritonitis should be kept in mind during the differential diagnosis of patients admitted with the triad of ascites, fever, and abdominal distention.
Insights
Tuberculous peritonitis, often mistaken for malignancy, presents with ascites, fever, and abdominal distention. Early diagnosis and treatment lead to a high recovery rate, with 96.2% of patients responding well.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Tuberculous peritonitis diagnosis is challenging due to subtle symptoms and resemblance to abdominal cancers.
- Systematic review and pooled analysis of Turkish case reports over a decade were conducted.
Purpose of the Study:
- To review and analyze cases of tuberculous peritonitis in Turkey.
- To identify key diagnostic features and treatment outcomes.
Main Methods:
- Systematic review of 34 articles and pooled analysis of 163 tuberculous peritonitis cases from Turkey.
- Data extraction on demographics, clinical presentation, diagnostic findings, and treatment response.
Main Results:
- The majority of patients (98.6%) were female, with a mean age of 34.1 years.
- Common symptoms included abdominal pain (77.4%) and distention (73.5%); key findings were ascites (75%) and fever (42%).
- Diagnostic tests showed variable sensitivity: acid-fast bacilli (23.3%), culture (22.2%), and PCR (20%); elevated CA-125 was noted in 96.7%.
Conclusions:
- Tuberculous peritonitis should be considered in patients presenting with ascites, fever, and abdominal distention.
- Prompt diagnosis and antitubercular therapy result in a favorable prognosis, with a 96.2% good treatment response rate.
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