Peritoneal Tuberculosis

  • – Abdominal involvement occurs in upto 5% of TB patients
    – 15-50% of patients with GI involvement may have active pulmonary disease
    – Tuberculosis skin test positive in 70% cases
    Spread of the organism to peritoneum occur
    • Through the bowel wall
    • Direct extension from gynecological tract
    • Hematogenous spread from pulmonary focus
    – Chest radiograph abnormal in 2/3rd patients but active pulmonary TB present in only 14% cases
    – Culture positive in 20% cases
    Ascitic fluid study
    • Protein >2.5 gm/dl
    • Glucose <30mg/dl
    • WBC>250 cell/μl, lymphocyte predominant
    – Daiagnostic laparoscopy
    • Gold standard test
    • Can diagnose >85% cases 
  •   • Small (<5mm), scattered, yellowish-white nodule of fairly uniform size coating visceral peritoneum and parietal peritoneum
    ** In peritoneal carcinomatosis: Whitish nodule of variable size
    Culture can detect 10-100 bacilli/ml of ascetic fluid sample in TB
    MTB can be cultured from 10-30% of mucosal biopsies in colonic TB

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