Background: Peritoneal tuberculosis (PT) and peritoneal malignancy (PM) are the most frequent causes of exsudate ascitic fluid but the different diagnosis between the former and the latter is also difficult and elusive. Objective: To study the difference of clinical and laparoscopic features between PT and PM. Subjects and method: 76 patients with PT and 50 with PM were diagnosed by laparoscopy and peritoneal biopsy. Ascitic mycobacterium tuberculosis was detected by PCR analysis. Exsudate ascites was confirmed according to criteria of Light. Results and Conclusions: Average age of PT was younger than of PM (p < 0.001). The frequency of fever, pleural effusion in the patients with PT was higher than those in PM (p < 0.001 and 0.05). The anemia and abdominal tumefaction in those of PM was more frequent than in those of PT (p < 0.05 and 0.001). High protein ascitic fluid and numerous lymphocytes in the patients with PT was frequent than in those with PM (p < 0.05). Laparoscopic features: In those patients with PT the white "miliary nodules" or adhesions between abdominal wall was more frequent than in those with PM (p < 0,05) and in patients with PM omental thickening, tumor formation was more than in those with PT.
Peritonitis ; Tuberculous/pathology ; diagnosis ; Laparoscopy

Paradoxical response during antituberculosis treatment occurs frequently in non-HIV-infected patients as well as in HIV-infected patients, and intraperitoneal tuberculous abscess can develop as paradoxical response in tuberculous peritonitis patients rarely. The unique CT findings are not present and microbiologic or pathologic confirm is needed for diagnosis of intraperitoneal tuberculous abscess. Further study is needed to define steroid use or operation indication of intraperitoneal tuberculosis abscess.
Abscess ; Humans ; Peritonitis, Tuberculous ; Tuberculosis

No abstract available.
Peritonitis*

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis, Tuberculous*

The tuberculous peritonitis, especially in pregnancy, is very rare and difficult to diagnose since there is no diagnostic clue and limitation of diagnostic means. The clinical features may vary such as fever, chill, tachycardia, abdominal tenderness or rebound tenderness which are not controlled easily with antibiotics. It is possible to diagnose by AFB culture and biopsy through exploro-laparotomy which is done due to uncontrolled symptoms even to unstable vital signs. It's clinical symptoms and signs are dramatically improved with antituberculotic therapy. Recently we have experienced a case of tubeculous peritonitis at 29 weeks gestation which was diagnosed through exploro-laparotomy including cesarean section. So we report this case with a brief review of literature
Anti-Bacterial Agents ; Biopsy ; Cesarean Section ; Female ; Fever ; Peritonitis ; Peritonitis, Tuberculous* ; Pregnancy* ; Tachycardia ; Vital Signs

Infliximab is a chimeric monoclonal antibody against tumor necrosis factor-alpha (TNF-alpha) that is used to treat chronic inflammatory diseases such as ankylosing spondylitis (AS). Side effects include greater susceptibility to severe infections, such as tuberculosis. Positive diagnosis of tuberculous infections, such as tuberculous peritonitis, are often difficult due to the nonspecific nature of symptoms and the rarity of the infection, with definitive diagnoses requiring either a positive culture or histological biopsy. Here, we describe a case of tuberculous peritonitis during infliximab therapy in a 71-year-old man with AS; the disease was confirmed via histopathological examination.
Aged ; Biopsy ; Diagnosis ; Humans ; Peritonitis ; Peritonitis, Tuberculous* ; Spondylitis, Ankylosing* ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Infliximab

Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

Rupture of teratoma is rare. Ovary cystic teratoma was occurred 95% in benign ovary tumor, but chemical peritonitis arising from ruptured cystic teratoma is a scarce case. Peritoneal tuberculosis is also rare disease nowadays. It causes easily fatigue, abdominal distension, intermittent abdominal pain and ascities insidiously. We have recently experienced a case of chemical peritonits from ruptured both ovary cystic teratoma of ovary with superimposed peritoneal tuberculosis in 44 year-old woman and report our scarce case with a brief review of the literature.
Abdominal Pain ; Adult ; Fatigue ; Female ; Humans ; Ovarian Cysts* ; Ovary ; Peritonitis* ; Peritonitis, Tuberculous* ; Rare Diseases ; Rupture ; Teratoma*

PURPOSE: We assessed the feasibility and efficacy of a laparoscopic approach in surgically managing various conditions of the acute abdomen. METHODS: This report presents preliminary data from our ongoing prospective study. Sixty patients underwent a diagnostic or a therapeutic laparoscopy for acute or subacute abdominal conditions between July 1997 and September 1998. RESULTS: Conditions were classified into trauma (n=8), peritonitis (n=41), and obstruction (n=11). Trauma included 5 blunt (2 small bowel perforations, 1 spleen rupture, 2 mesenteric ruptures) and 3 stab injuries. Peritonitis included 23 duodenal ulcer perforations, 10 acute cholecytitis/empyema, 3 colon perforations, 1 tuberculous peritonitis, 1 ectopic pregnancy, 1 ruptured corpus luteum, 1 appendicitis, and 1 ruptured liver abscess. Obstruction included 5 intussusceptions (4 Children, 1 adult), 2 intestinal adhesions; and 4 congenital hypertropic pyloric stenoses. Among the 54 cases of therapeutic laparoscopy, 9 cases were converted during the procedure (conversion rate: 16.7%). There were 2 intraoperative (bowel perforation) and 4 postoperative (1 subphrenic abscess, 1 incomplete adhesiolysis, 1 port site hernia, 1 port-site seroma) complications. CONCLUSION: Our preliminary data may justify further clinical study to clarify the role of laparoscopy in managing acute or subacute abdominal conditions.
Abdomen, Acute* ; Appendicitis ; Child ; Colon ; Constriction, Pathologic ; Corpus Luteum ; Duodenal Ulcer ; Female ; Hernia ; Humans ; Intussusception ; Laparoscopy* ; Liver Abscess ; Peritonitis ; Peritonitis, Tuberculous ; Pregnancy ; Pregnancy, Ectopic ; Prospective Studies ; Rupture ; Spleen ; Subphrenic Abscess

PURPOSE: To compare the CT findings of peritoneal tuberculosis (PT) and peritoneal carcinomatosis (PC) based on the morphologic features of the peritoneum and assess the relationship between the degree of peritoneal thickness and the severity of omental infiltration in PT and PC. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 15 patients with PT and 14 with PC. We checked the morphologic changes of the peritoneum as seen on CT, for the following points: 1) the presence of peritoneal change: 2) the pattern of any change-diffuse thickening, plaque or nodularity, combined thickening (diffuse and plaque, or nodularity); 3) the degree of thickness on the whole peritoneum - mild (grossly definite, but not more than 3 mm), moderate (more than 3mm); 4) the presence of irregularity on the peritoneal surface. We also evaluated the significance of the relationship between peritoneal thickness and omental infiltration in both disease entities. The degree of omental infiltration was described as follows : grade I (no change or focal smudge pattern); grade II ( diffuse smudge), grade III (omental cake regardless extent). RESULTS: Peritoneal change was seen in 12 of 15 PT patients and in 7 of 14 PC patients. In all 12 PT patients, the pattern of change was diffuse thickening, and among the seven PC patients, there was diffuse thickening in one, plaque or nodular thickening in four, and combined thickening in two. In PT patients, the degree of thickness on the whole peritoneum was mild in six and moderate in six, and in PC patients it was mild in two and moderate in one. An irregular peritoneum surface was seen in one patient with PT and in two with PC. The degree of omental infiltration in PT was grade I in four patients, grade II in six andgrade III in five. In PC, it was grade I in six patients, grade II in two and grade III in six. Smooth diffuse thickening of the peritoneum was seen in 11 of 15 PT cases and in one of 14 PC (P<0.01). Accompanying plaque or nodularity was seen only in PC, in six of 14 patients (P<0.001). The relationship between the degree of peritoneal thickness and severity of omental infiltration was significantly proportional in PT (r=0.900, P<0.001), but not in PC (r=0.068, P>0.5). CONCLUSION: In PT and PC different CT findings based on peritoneal morphologic changes might be useful in differentiating these two entities. In addition, careful observation of relationship between the peritoneal change and the severity of omental infiltration is necessary.
Carcinoma* ; Humans ; Peritoneum ; Peritonitis, Tuberculous* ; Retrospective Studies ; Tuberculosis