Study of TB peritonitis in Iran during recent 40 years

Background: Prevalence of tuberculosis is considerable in developing countries and its first manifestation maybe peritonitis. The prevalence of disease in all of the countries maybe increased with HIV contamination in future years. Objective: To assess the clinical and paraclinical aspects of the TB peritonitis in two teaching hospitals of Tehran university in recent forty years. Methods: This retrospective study was done on patients that admitted in Tehran’s Imam khomeini and Amiralam hospitals between 1959 to 1999 confirmed TB peritonitis diagnosis with smear, pathology or culture. Findings: Samples were 183 patients (35 male and 148 female) with 29.5 14.24 years on average. Disease in female is seen more than male (P<0.05). The most prevalent signs of the disease were abdominal distension (78%), weight loss (75%), fever (75%), abdominal pain (62%) and abdominal mass (40%). Pulmonary tuberculosis was seen in 78 patients (43%). PPD was positive in 157 patients (85%). Estimated sedimentation rate was 67.7 and above 100 in 23% of patients. Ascitis was present in 150 patients (81.9%) that more than 90% were exudative with lymphocyte predominant. Bloody ascitis was present in 23.3% . Laparoscopy was done in 100 patients and pathology was positive in 75% of them. Conclusion: Noticing the results, the TB peritonitis must be considered in young patients specially women with abdominal pain and mass, fever, weight loss and positive PPD test. Laparoscopy or laparatomy is definite diagnostic way for TB peritonitis.