title: Presentation and role of peritoneoscopy in the diagnosis of tuberculous peritonitis.
abstract: This study represents the clinical and laboratory features of 135 tuberculous peritonitis cases in whom peritoneoscopic investigation was used routinely. Disease was more common in women than men (1.5:1) and was most frequently encountered in the third and fourth decades in life. The most common presenting symptoms were abdominal distension (96%), abdominal pain (82%), weight loss (80%), weakness (76%), loss of appetite (73%) and fever (69%). The most common physical findings were ascites (96%), fever (75%) and abdominal tenderness (43%). One hundred and twenty-nine cases (95.5%) showed exudative type tuberculous peritonitis with variable amounts of ascites and filmy adhesions. In six patients (4.5%) the disease was of the plastic (dry) type. Peritoneoscopic investigations of 139 patients suggested tuberculous peritonitis but four cases showed histologically proven malignancy (3%). Laparoscopic diagnoses of the remaining cases were confirmed by histology (97%). The laparoscopic appearance of scattered yellowish-white nodules, approximately 1-5 mm in size, on the peritoneal surfaces, and filmy adhesions were suggestive of tuberculous peritonitis. A non-fatal colon perforation occurred as a major complication. After antituberculous therapy patients were followed for at least 1 year. Peritoneoscopy with simultaneous biopsy is the ideal and most accurate diagnostic modality in the diagnosis of tuberculous peritonitis.
authors.affiliation: Department of Gastroenterology, Cukurova University Medical Faculty, Adana, Turkey.
authors.forename: M U
authors.initials: MU
authors.lastname: Sandikçi
authors.forename: S
authors.initials: S
authors.lastname: Colakoglu
authors.forename: Y
authors.initials: Y
authors.lastname: Ergun
authors.forename: S
authors.initials: S
authors.lastname: Unal
authors.forename: H
authors.initials: H
authors.lastname: Akkiz
authors.forename: S
authors.initials: S
authors.lastname: Sandikçi
authors.forename: S
authors.initials: S
authors.lastname: Zorludemir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000995:Antitubercular Agents