Tuberculous peritonitis in children: report of nine patients and review of the literature.
OBJECTIVE
To present our experience with tuberculous peritonitis treated in our hospital from 2002-2007.


METHODS
We reviewed the medical records of 9 children with tuberculous peritonitis.


RESULTS
Nine patients (5 boys, 4 girls) of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications.


CONCLUSIONS
Tuberculous peritonitis has to be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.
Dinler
Gönül
G
Division of Gastroenterology, Hepatology and Nutrition, Ondokuz Mayis University Hospital, Kurupelit, Samsun, 55139, Turkey. gdinler@omu.edu.tr
Sensoy
Gülnar
G
Helek
Deniz
D
Kalayci
Ayhan Gazi
AG
D015746:Abdominal Pain / Q000175:diagnosis; D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D001201:Ascites / Q000175:diagnosis; D001706:Biopsy; D002648:Child; D005260:Female; D005334:Fever / Q000175:diagnosis; D006801:Humans; D008297:Male; D010537:Peritoneum / Q000473:pathology; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies
D000995:Antitubercular Agents