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Tuberculous peritonitis--do not miss it

G B Lisehora1, C C Peters, Y T Lee

  • 1Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA.

Diseases of the Colon and Rectum
|April 1, 1996
PubMed
Summary
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Tuberculosis peritonitis is increasingly diagnosed late, causing severe illness. Early diagnosis via CT scans and laparotomy with biopsy is crucial for effective medical treatment and cure.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Pulmonology

Background:

  • Tuberculosis peritonitis incidence is rising in the US.
  • Late diagnosis leads to significant patient morbidity and mortality.

Purpose of the Study:

  • Identify optimal clinical, laboratory, and procedural tests for diagnosing tuberculous peritonitis.

Main Methods:

  • Retrospective review of 28 tuberculous peritonitis cases (1982-1994).
  • Analysis of laboratory, radiographic, and invasive diagnostic procedures.

Main Results:

  • Computed tomographic (CT) scans were suspicious in 16/17 patients.
  • Laparotomy with tissue biopsy was diagnostic in 20/20 patients.
  • Traditional tests like purified protein derivative (PPD) and chest X-rays had low sensitivity.

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Conclusions:

  • Tuberculosis peritonitis is treatable with prompt diagnosis and medical therapy.
  • CT scan is the most useful radiographic study.
  • Mini laparotomy with tissue biopsy offers the highest diagnostic sensitivity and specificity.