Peritoneal tuberculosis

• Published in: Clinics and research in hepatology and gastroenterology 2011-01, Vol.35 (1), p.60-69
• Main Authors: Guirat, A, Koubaa, M, Mzali, R, Abid, B, Ellouz, S, Affes, N, Ben Jemaa, M, Frikha, F, Ben Amar, M, Beyrouti, M.I
• Format: Article
• Language: English
• Subjects: Gastroenterology and Hepatology; Humans; Internal Medicine; Peritonitis, Tuberculous - diagnosis; Peritonitis, Tuberculous - therapy
• ISSN: 2210-7401; 0399-8320; 2210-741X
• DOI: 10.1016/j.gcb.2010.07.023

Summary The peritoneum is one of the locations outside the most common pulmonary tuberculosis. Peritoneal tuberculosis poses a public health problem in endemic regions of the world. The phenomenon of migration, the increased use of immunosuppressive therapy and the epidemic of AIDS have contributed to a resurgence of this disease in regions where it was previously controlled. The aim of this review is to expose the clinical, biologic end radiologic futures of the peritoneal tuberculosis and to present the methods of diagnosis and treatment. The diagnosis of this disease is difficult and still remains a challenge because of its insidious nature, the variability of presentation and limitations of available diagnostic tests. The disease usually presents a picture of lymphocytic exudative ascites. There are many complementary tests with variable sensitivities and specificities to confirm the diagnosis of peritoneal tuberculosis. Isolation of mycobacteria by culture of ascitic fluid or histological examination of peritoneal biopsy ideally performed by laparoscopy remains the investigation of choice. The role of PCR, ascitic adenosine deaminase, interferon gamma and the radiometric BACTEC system can improve the diagnostic yield. An antituberculous treatment with group 1 of the WHO for 6 months is sufficient in most cases.