Peritoneal tuberculosis – report of 43 cases
Keywords:
peritoneal tuberculosis, coelioscopy, peritoneal biopsyAbstract
Background: Peritoneal tuberculosis represents 0, 1 to 4% of all forms of tuberculosis.
Aim : The aim of our study is to describe clinical, therapeutic characteristics and the outcome of peritoneal tuberculosis.
Methods: Retrospective study of all cases of peritoneal tuberculosis diagnosed in gastroenterology B department – Rabta Hospital during a 12 years period (1996 to 2007).
Results: Forty three cases of peritoneal tuberculosis were included: 15 male and 28 female with mean age of 38years (extremes: 16 to 85years). Five patients were cirrhotic. Clinical manifestations were dominated by ascitis (83%). Ascitic fluid were exsudative in 97% of cases and lymphocytic in all cases. The diagnostic was based on coelioscopy with peritoneal biopsy in 26cases demonstrating caseating granulomatous lesions in 64% of cases. Extra peritoneal tuberculosis was noted in 60, 4% dominated by pleuro-pulmonary localisations. Patients were given antituberculous therapy for a mean duration of 9, 8 months and the outcome was favourable in 93%.
Conclusion: Peritoneal tuberculosis is still a medical problem in Tunisia. It is more common in young female. Diagnosis is based on the results of peritoneal biopsies during coelioscopy.
Downloads
References
E.Verspyck, C.Struder, D.Wendum et al; Tuberculose péritonéale. Annales de chirurgie 1997;51 : 375-8
S.El Ajmi, N.Chatti, K.Limam. La tuberculose péritonéale. Aspects actuels. APropos de 39 cas observés au centre tunisien. Med Chir Dig 1992;21:87-8
E.Vardareli, M.Kebapct,T.Saricam and al. Tuberculous peritonitis of the wet ascitic type: clinical features and diagnostic value of image-guided peritoneal biopsy. Digestive and Liver Disease 2004; 36: 199-204
M.I.Beyrouti, R.Beyrouti, M.B.Amer, N.Dhieb, W.Zouari, N.Affes, I.Fki, A.Ghorbel, M.S.Krichen, A.Sellami. La tuberculose encapsulante d'origine tuberculeuse. A Propos de 18 cas. La Tunisie Médicale 2005 ; 83: 694-9
A.Hamdani, N.Sekkat, A.Alyoune, M.Merzouk, S.Moufid, A.El Meknassi, A.Mourad. La tuberculose péritonéale chez l'adulte. Etude de 207cas. Ann de Gastroenterologie et d'Hépatologie 1987; 23: 115-22
M.El. Abkari, D.Benajah, N.Aqodad, B.Oudghiri, A.Ibrahimi. Peritoneal tuberculosis in the Fes University Hospital (Morrocco). Report of 123cases. Gastroenterol Clin Biol 2006; 30 : 377-81
Aguado JM,Pons F, Casafont F, San Miguel, Valle R. Tuberculous peritonitis: a study comparing cirrhotic and noncirrhotic patients. J Clin Gastroenterol 1990; 12:550-4
Andrea Salmi. Tuberculous peritonitis and liver cirrhosis. The Western J of Med 1986; 144: 476-7
Tzoanopoulous D, Mimidis K, Giaglis S et al. The usefulness of PCR amplification of the IS6 110 insertion element of M. tuberculosis complex in ascetic fluid of patients with peritoneal tuberculosis. Eur J Intern Med 2003; 14:367-71
F.M.Sanai, K.I.Bzeizi. Systematic review: tuberculosis peritonitispresenting features, diagnosis and treatment. Aliment Pharmacol Ther 2005; 22:685-700.
M.P.Sharma and V.Bhatia. Abdominal tuberculosis. Indian J Med Res 2004; 120: 305-15
J.Kharrat, D.Gargouri, A.Ouakaa, N.Belhadj, A.Kilani, A.Kochlef et al. Aspects laparoscopiques de la tuberculose péritonéale; à propos de 163 cas. La Tunisie médicale 2003; 81 : 558-562
J.M.Kasia, E.Verspyck, G. Le Bouêdec et al. Tuberculose péritonéale- Apport de la coelioscopie. J Gynecol Obstet Biol Reprod 1997; 26:367-73
D.Hammoudi, I. Bonatiro, Dahmane Younsi M, Djoudi H, et al. Diagnostic des péritonites tuberculeuses par la laparoscopie. Rev. Service Santé ANP 1975; 8: 93- 7
G.Nicolet, T.Rochat, J.P.Zellweger. Traitement de la tuberculose. Forum Med Suisse 2003; 22: 506-16
