Abstract

Tuberculous peritonitis has often been overlooked in the differantial diagnosis of abdominal diseases because of variability and nonspecifity in clinical presentation. We aimed to evaluate diagnostic methods for accurate approach to patients with tuberculous peritonitis. In the study, we examined retrospectively 16 patients [mean age 33.3 years (range: 15-65 years), 13 (81%) female, 3 (19%) male] diagnosed as peritoneal tuberculosis at our center between January 1997 and January 2001.

Symptoms of peritoneal tuberculosis were abdominal pain (87%), weight loss (87%) and abdominal distention resulting from ascites (50%). Ascites was also one of the most common finding in ultrasonography and computerized tomography (94%). The tuberculin skin test of the 11 patients were negative (69%). Pulmonary tuberculosis was found in 11 patients (69%). Diagnosis was confirmed by peritoneal biopsy in 13 cases, dominity of lymphocytes in ascitic fluid and clinical findings in two cases and colonoscopic biopsy in one case. All patients were treated with isoniazide (H), rifampicin (R), pyrazinamide (P), ethambutol (E) combination for a period of 9 to 12 months. Peritoneal tuberculosis should be considered in patients with abdominal pain, weight loss and ascites especially in endemic countries like Turkey.