TUBERCULOUS PERITONITIS - A STUDY COMPARING CIRRHOTIC AND NONCIRRHOTIC PATIENTS

被引:60
作者
AGUADO, JM
PONS, F
CASAFONT, F
MIGUEL, GS
VALLE, R
机构
[1] UNIV CANTABRIA,NATL HOSP MARQUES VALDECILLA,DEPT MED,INFECT DIS UNIT,SANTANDER,SPAIN
[2] UNIV CANTABRIA,NATL HOSP MARQUES VALDECILLA,DEPT MED,GASTROENTEROL SERV,SANTANDER,SPAIN
关键词
Adenosine deaminase; Peritonitis; Tuberculosis;
D O I
10.1097/00004836-199010000-00013
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Tuberculous peritonitis is a rare disease, which often goes unrecognized because of the subtle clinical clues and its insidous onset. We retrospectively analyzed the records of 37 cases of tuberculous peritonitis diagnosed over a 15-year period, and compared the clinical and diagnostic features of cirrhotic and noncirrhotic patients. In cirrhotic patients, tuberculous peritonitis can simulate as-cites from liver disease or spontaneous bacterial peritonitis. The diagnosis is difficult in these patients because the ascitic fluid may not be of the exudative type as a result of the low albumin level in serum, and lymphocytes do not predominate in all cases. Adenosine deaminase (ADA) activity in ascitic fluid was elevated (higher than 40 U/L) in all 11 patients (four patients with hepatic cirrhosis). The time required to achieve a correct diagnosis was significantly longer in cirrhotic than in noncirrhotic patients. The overall mortality was 13%, with deaths occurring exclusively among cirrhotic patients. We emphasize that tuberculous peritonitis in cirrhotic patients can present an atypical picture. A considerable element of suspicion is necessary. © 1990 Raven Press, Ltd., New York.
引用
收藏
页码:550 / 554
页数:5
相关论文
共 24 条
[1]  
BASTANI B, 1985, Q J MED, V56, P549
[2]   TUBERCULOUS PERITONITIS - A STUDY OF 47 PROVED CASES ENCOUNTERED BY A GENERAL MEDICAL UNIT IN 25 YEARS [J].
BURACK, WR ;
HOLLISTER, RM .
AMERICAN JOURNAL OF MEDICINE, 1960, 28 (04) :510-523
[3]   LAPAROSCOPIC DIAGNOSIS OF TUBERCULOUS ASCITES [J].
DELOPE, CR ;
JOGLAR, GSM ;
ROMERO, FP .
ENDOSCOPY, 1982, 14 (05) :178-179
[4]   TUBERCULOUS PERITONITIS - 43-YEARS EXPERIENCE IN DIAGNOSIS AND TREATMENT [J].
DINEEN, P ;
HOMAN, WP ;
GRAFE, WR .
ANNALS OF SURGERY, 1976, 184 (06) :717-722
[5]  
FERNANDEZGUERRERO ML, 1980, REV CLIN ESP, V159, P119
[6]   PERITONEOSCOPY IN THE DIAGNOSIS OF TUBERCULOUS PERITONITIS [J].
GEAKE, TMS ;
SPITAELS, JM ;
MOSHAL, MG ;
SIMJEE, AE .
GASTROINTESTINAL ENDOSCOPY, 1981, 27 (02) :66-68
[7]  
Giusti G., 1974, METHOD ENZYMAT AN, P1092, DOI DOI 10.1016/B978-0-12-091302-2.50108-0
[8]   TUBERCULOUS PERITONITIS - CT APPEARANCE [J].
HANSON, RD ;
HUNTER, TB .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1985, 144 (05) :931-932
[9]   ABDOMINAL TUBERCULOSIS - CT EVALUATION [J].
HULNICK, DH ;
MEGIBOW, AJ ;
NAIDICH, DP ;
HILTON, S ;
CHO, KC ;
BALTHAZAR, EJ .
RADIOLOGY, 1985, 157 (01) :199-204
[10]   SPECTRUM OF TUBERCULOUS PERITONITIS [J].
KARNEY, WW ;
ODONOGHUE, JM ;
OSTROW, JH ;
HOLMES, KK ;
BEATY, HN .
CHEST, 1977, 72 (03) :310-315