[Clinico-statistical study on tuberculous peritonitis and genital tuberculosis in elderly women]

We clinico-statistically studied 8 patients (0.77%) with tuberculous peritonitis (3 cases) and tuberculous endometritis (5 cases) aged 50 or older who visited our gynecological clinic for 6 years from July, 1986 to June, 1992 in Tokyo Metropolitan Tama Geriatric Hospital. The mean age was 72 years with a range of 52 to 82 years. Five cases with tuberculous endometritis were diagnosed based on the findings of endometrial cytology and bacteriology, and the incidence was 0.93% of 535 cases in which the uterine cavity could be examined. Three cases with tuberculous peritonitis were strongly suspected by the ascitic findings (cytology and adenosine deaminase level), and culture of ascitic fluid for acid-fast bacilli was positive in 2 of the three cases. Another case with negative culture was diagnosed based on the marked improvement of clinical findings and symptoms during chemotherapy for tuberculosis. No cases were complicated by active lung tuberculosis. All cases had a family and/or past history of pulmonary tuberculosis. The PPD skin test was positive in 7 of the 8 cases. In all cases, the clinical laboratory data and symptoms were markedly improved by chemotherapy for tuberculosis. Endometrial cytology and transvaginal ultrasonography were very effective methods for the diagnosis of tuberculous endometritis and peritonitis associated with ascites.