Tuberculous Peritonitis

Abstract

Of 47 patients with tuberculous peritonitis followed for an average of three years x-ray examination showed a parenchymal pulmonary lesion in only 6 per cent. Barium-enema and barium-meal studies, intravenous pyelography and salpingography revealed no tuberculous lesion in the adjacent organs in this series. With the use of about 1 liter of ascitic fluid, acid-fast bacilli were cultured in 83 per cent of the patients. Percutaneous peritoneal biopsy proved to be a simple and useful method of arriving at a quick diagnosis, and a caseating granuloma was demonstrated by this technic in 64 per cent. Other serous membranes were often involved in patients with tuberculous peritonitis. Pleural effusion was present in 32 per cent and cryptic pericarditis characterized by electrocardiographic changes only in 13 per cent. Antituberculous drugs were highly effective, and concomitant use of steroids prevented the late fibrotic complications of tuberculosis in the form of constrictive pericarditis and intestinal obstruction from adhesive bands.