Tuberculous peritonitis

Mycobacterium tuberculosis peritonitis caused by chronic diffuse peritoneal infection. To children, young adults often. Women slightly more than men, as 1.2-2.0:1.

[Etiology and Pathogenesis]
Most of tuberculous peritonitis secondary to tuberculosis of other organs change. Route of transmission of the disease can be spread directly or intra-abdominal tuberculosis from hematogenous spread. The former is more common, such as intestinal tuberculosis, mesenteric lymph nodes of nuclear, tubal tuberculosis, the disease can be directly based primary lesions. More women than men, probably because of retrograde pelvic tuberculosis infection.

[Clinical manifestations]
The clinical manifestations of tuberculous peritonitis with the primary tumor, infection routes, pathological type and body reactivity vary, different priorities onset of the disease. Most moderate onset, but the number of acute onset Zheyi not fresh. Onset, the main symptoms are fatigue, fever, abdominal distension and abdominal pain, have chills, fever are sudden onset. Cases began to light was insidious condition.
First, the general performance of fever and night sweats, the most common, accounting for about 67-95%, medium-hot type to hot and mostly low heat, sweating severe late anemia, weight loss, edema, glossitis, angular cheilitis and vitamin A malnutrition, lack of psychosis performance. In women of childbearing age, menopausal infertility are more common.
Second, about two-thirds of the patients with abdominal pain can occur in different degrees of abdominal pain, mostly persistent pain or dull pain, pain and more at Cullen, lower abdomen, sometimes in the whole abdomen.
Third, the majority of patients with abdominal distention and bloating sense of ascites can be symptoms of tuberculosis peritonitis associated with or caused by intestinal dysfunction. About one-third of patients, there may be ascites.
Fourth, a sense of flexibility and a sense of abdominal wall flexibility is due to mild irritation or chronic peritoneal inflammation was caused.
V. adhesion abdominal mass in patients with type and type of cheese often palpable abdominal mass, usually located in the lower abdomen.
Six other patients, there may be some diarrhea.

[Laboratory examinations]
First, the blood picture, erythrocyte sedimentation rate and tuberculin test. White blood cell count were normal or slightly higher, a few low. Acute abdominal spread of tuberculosis or cheese type of white blood cell count can be increased in patients, erythrocyte sedimentation rate can be as simple indicators of disease activity, disease activity in this period is generally faster, lesions tend to rest gradually to normal. Tuberculin test was strongly positive in the diagnosis of the disease has helped, but in miliary tuberculosis or critically ill patients but can be negative.
Second, check the ascites ascites was straw yellow exudate.
Third, gastrointestinal X-ray diagnosis of the disease secondary value.
Fourth, extensive adhesions laparoscopy with peritoneal examination is contraindicated.