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Diagnostic and Therapeutic Strategies for peritoneal tuberculosis: A Review

Journal of Clinical and Translational Hepatology 2019年第2期7卷 140-148页

作者： David C.Wu Leon D.Averbukh George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

peritoneal tuberculosis(PTB),although rarer than its pulmonary counterpart,is a serious health concern in regions of the world with high tuberculosis prevalence.Individuals with baseline immunocompromise condition,whether acquired or medically induced,are at greatest risk for experiencing PTB.While medical treatment of the condition is similar to that of the pulmonary disease,the generally immunocompromised state of those infected with PTB,along with a lack of highly sensitive and specific testing methods make early diagnosis difficult.This review discusses the risks factors,clinical features,diagnostic methods,and treatment options for PTB.

关键词： peritoneal tuberculosis tuberculosis Liver disease Human immunodeficiency virus

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Comparison between peritoneal tuberculosis and primary peritoneal carcinoma： a 16-year, single-center experience

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Chinese Medical Journal 2012年第18期125卷 3256-3260页

作者： WANG Dan ZHANG Jun-ji HUANG Hui-fang SHEN Keng CUI Quan-cai XIANG Yang Department of Obstetrics and Gynecology Peking Union Medical College Hospital Chinese Academyof Medical Sciences and Peking Union Medical College China Beijing100730 Department of-Pathology Peking Union Medical College Hospital Chinese Academyof Medical Sciences and Peking Union Medical College China Beijing100730

Background peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125. The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis, compare them with features of primary peritoneal carcinoma, and establish definitive diagnostic procedures. Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital. During this time, the data of 38 patients with primary peritoneal carcinoma were reviewed. Results The median age was 34 years （range, 19-80 years）. The most common symptoms were abdominal distension （16/30, 53.3%） and an abdominal mass （12/30, 40.0%）. The serum CA125 level was elevated in 25 patients （83.3%）. The median level of cancer antigen CA125 was 392.5 U/ml （range, 0.6-850.0 U/ml）. Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients. Diagnostic laparoscopy was performed in 15 patients （50.0%） and exploratory laparotomy was performed in 12 patients （40.0%）, and 3 patients （10.0%） who underwent laparoscopy converted to laparotomy because of severe adhesions. The intraoperative findings were adhesions, multiple white tubercles, and ascites. Frozen tissue sections were obtained in 17 patients, and 14 of whom showed chronic granulomatous reactions. Final pathological examinations confirmed the diagnosis. Conclusions peritoneal tuberculosis should be considered as a differential diagnosis, especially for young women with an abdominal mass, ascites, and elevated serum CA125 levels. Laparoscopy is a useful diagnostic method for peritoneal tuberculosis, and intraoperative frozen sections are recommended when the diagnosis is in doubt.

关键词： peritoneal tuberculosis primary peritoneal carcinoma, laparoscopy frozen section

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Appendicular tuberculosis:The resurgence of an old disease with difficult diagnosis

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World Journal of Gastroenterology 2010年第4期16卷 518-521页

作者： Francesco Barbagallo Saverio Latteri Maria Sofia Agostino Ricotta Giorgio Castello Andrea Chisari Valentina Randazzo Gaetano La Greca Department of Surgical Sciences Transplantation and New TechnologiesUniversity of CataniaVia Messina 35495126 CataniaItaly

Gastrointestinal tuberculosis(TB) is quite rare,representing only 3% of all extra-pulmonary cases.Blind gut and ileum are the most common gastrointestinal localizations,while appendix involvement is infrequent.Appendix involvement is usually related to symptoms of acute appendicitis since the caseous necrosis may lead to adhesions and surgical complications such as perforation.For this reason patients with suspected appendicular TB usually undergo surgery even without a secure diagnosis.In these cases,due to the absence of specific symptoms and signs,the diagnosis is delayed after surgery,thus resulting in a high percentage of important,and sometimes lethal,complications.Histopathological examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy,while an early diagnosis could avoid surgical treatment.We report a case of appendicular TB not only for its rarity but also todiscuss the difficulty in its diagnosis.

关键词： Appendicitis peritoneal tuberculosis Peritonitis tuberculosis

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