Tuberculous Peritonitis Diagnosed by Laparoscopy.
- Author:
Jung Ho SHON
1
;
Young Woo KANG
;
Tae Hee LEE
;
Kyu Chan HUH
;
Du Young KWON
;
Kyung Sik PARK
;
Kwang Bum CHO
;
Jae Seok HWANG
;
Sung Hoon AHN
;
Soong Kook PARK
Author Information
1. Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, Korea.
- Publication Type:Original Article
- Keywords:
Tuberculous peritonitis;
Laparoscopy
- MeSH:
Ascites;
Ascitic Fluid;
Biopsy;
Diagnosis, Differential;
Exudates and Transudates;
Female;
Granuloma;
Humans;
Incidence;
Inflammation;
Korea;
Laparoscopy*;
Lymphocytes;
Male;
Peritonitis, Tuberculous*;
Retrospective Studies;
Tuberculosis, Lymph Node;
Tuberculosis, Pulmonary
- From:Korean Journal of Gastrointestinal Endoscopy
2002;24(4):200-205
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Tuberculous peritonitis is still a very important cause of exudative ascites in Korea. We analized the clinical features and laparoscopic findings in patients with tuberculous peritonitis diagnosed by laparoscopy. METHODS: We studied 51 patients who had tuberculous peritonitis confirmed by laparoscopic biopsy from 1980 to 2000, in retrospective method. RESULTS: The ratio of male to female was 1:2. The peak incidence was between 21 and 40 years of age. The mean duration of symptoms is 60 days. The most frequent chief complaints and physical findings was abdominal fullness (88.2%) and shifting dullness (94.1 %). Involvement of other organs included pulmonary tuberculosis (27.4%), cervical tuberculous lymphadenitis (3.9%). The mean ascitic fluid protein concentration was 4.9 gm/dL, mean WBC count 1,240/mm3 and lymphocyte dominant exudate 88.2%. AFB smear was positive only one patient (2.0%). Tuberculous nodules on laparoscopy were noted in all of the patients. Histolologic findings were caseating granuloma (72.6%), non-caseating granuloma (19.6%) and nonspecific inflammation (7.8%). Tissue AFB stain was positive 10 patients (19.6%). CONCLUSIONS: Tuberculous peritonitis shows nonspecific clinical features. Therefore, laparoscopic examination with biopsy is the most useful method to make differential diagnosis of patients who are suspected tuberculous peritonitis.
