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[Echographic recognition of tuberculous peritonitis]
J E Portielje1, S D van der Werf, J A Mutsaers
1Afd. Inwendige Geneeskunde, Westeinde Ziekenhuis, Den Haag.
Nederlands Tijdschrift Voor Geneeskunde
|January 11, 1997
Summary
Ultrasonography (US) aids in diagnosing tuberculous peritonitis by identifying characteristic ascites and peritoneal thickening. US-guided puncture further confirms the diagnosis, reducing delays and avoiding surgery.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Gastroenterology
Background:
- Tuberculous peritonitis is a significant diagnostic challenge, particularly in endemic populations.
- Timely diagnosis is crucial to prevent complications and guide treatment.
Purpose of the Study:
- To evaluate the effectiveness of ultrasonography (US) and US-guided puncture in diagnosing tuberculous peritonitis.
- To assess the impact of these imaging modalities on diagnostic timelines.
Main Methods:
- Retrospective analysis of 12 patients with bacteriologically confirmed tuberculous peritonitis.
- Review of ultrasonographic findings and results of US-guided puncture (bacteriological and cytological).
Main Results:
- Ultrasonography accurately identified wet tuberculous peritonitis in 11 of 11 cases, showing loculated ascites and peritoneal thickening.
- US-guided puncture achieved bacteriological diagnosis in 8 patients and cytological confirmation in 2.
- Diagnostic delay was reduced, with US suggesting the diagnosis 3 days post-admission.
Conclusions:
- Ultrasonography is a valuable tool for diagnosing tuberculous peritonitis, especially the 'wet' form.
- US-guided puncture enhances diagnostic yield and accuracy.
- These methods significantly reduce diagnostic delay and the need for invasive surgical procedures.