Peritoneal tuberculosis. Report of seven cases.
BACKGROUND
Peritoneal tuberculosis (TB) is a misdiagnosed clinical entity of low frequency. Due to its rarity, it requires a high index of suspicion in clinical practice. Its incidence has been increasing in recent years.


METHODS
We present and analyze seven cases of peritoneal TB diagnosed and treated at four hospitals in Aguascalientes, Mexico during a 5-year period. Mean age of the patients was 47.5 +/- 6.5 years. There were six females and one male. Two patients had a history of treated lung TB. The most frequent clinical data were abdominal pain (six patients), ascites (four patients), and abdominal tumor (three patients). Symptom duration prior to surgery was 5.0 +/- 1.7 months. Abdominopelvic CT examinations revealed unilateral ovarian tumor in four patients, bilateral ovarian tumor in two patients, ascites in four patients, and retroperitoneal adenopathy in one patient. All female patients had elevated serum CA-125 levels with a median of 419 U/ml (range: 286-512 U/ml). All patients had a preoperative diagnosis of malignant tumor. All surgical procedures were elective and consisted of laparotomy with biopsy in three patients, laparotomy with salpingo-oophorectomy in two patients, and laparoscopy with biopsy in two patients. Diagnosis of TB was suspected in all cases during surgery. Mean hospital stay was 2 +/- 0.5 days. There was no postoperative morbidity or mortality.


CONCLUSIONS
Peritoneal TB is uncommon. Diagnoses should be considered in all patients with ascites, adnexal tumors and elevated serum CA-125 levels.
Centenario Hospital "Miguel Hidalgo," Instituto de Salud del Estado de Aguascalientes. Hospital General de Zona 1, Instituto Mexicano del Seguro Social, Aguascalientes, Mexico. efflorez@hotmail.com
Efrén
E
Flores-Alvarez
Sara Elena
SE
Tello-Brand
Froylán
F
López-López
Virgilio
V
Rivera-Barragán
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001201:Ascites / Q000209:etiology; D015415:Biomarkers; D018394:CA-125 Antigen / Q000097:blood; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007813:Laparotomy; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary; D014395:Peritonitis, Tuberculous / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D055815:Young Adult
D000995:Antitubercular Agents; D015415:Biomarkers; D018394:CA-125 Antigen