[Tuberculous peritonitis. 'Forgotten' disease]

Area of Science:

• Infectious Diseases
• Gastroenterology
• Radiology

Background:

• Tuberculous peritonitis presents with nonspecific symptoms, often complicating pulmonary tuberculosis and HIV-infection.
• Accurate diagnosis is challenging due to overlapping clinical presentations with other peritoneal diseases.

Purpose of the Study:

• To analyze the diagnosis and treatment of tuberculous peritonitis.
• To develop algorithms for instrumental examination and differential diagnosis.

Main Methods:

• Study included 48 patients with tuberculous peritonitis.
• Diagnostic tools: radiography, CT, ultrasound, laparoscopy, histological, cytological, microbiological, and molecular-genetic analysis of peritoneal samples.
• Exclusion criterion: signs of secondary peritonitis.

Main Results:

• Clinical presentation was nonspecific; 93.8% had prior pulmonary tuberculosis, 70.8% had HIV-infection.
• Diagnostic laparoscopy combined with cytological, molecular-genetic, and microbiological analysis achieved 87.2-95.8% diagnostic accuracy.
• Computed tomography was the most informative imaging method.

Conclusions:

• Tuberculous peritonitis should be suspected in patients with a history of tuberculosis or HIV-infection.
• Computed tomography is highly informative for diagnosis.
• Diagnostic laparoscopy with biopsy and comprehensive laboratory analysis is crucial for definitive diagnosis.