A Clinical Analysis of Laparoscopically Confirmed Tuberculous Peritonitis / 대한소화기내시경학회지

ABSTRACT

This is a clinical analysis of 48 patients who had tuberculous peritonitis laparoscopically confirmed at the Gastroenterologic Department of the Korea University Hae Wha Hospital from March 1980 to February 1988, and the results are as fallows 1) The ratio of male to female was 11.7, and the age of the peak incidence was the third decade. 2) The freqeent symptoms were abdominal distension (77.1%), abdominal pain (60.4%), and fever (60.4%); others were indigestion (27.1%), diarrhea (18.8%), weight loss (6.3%), abdominal mass (6.3%), vomiting (6.3%), and dysmenorrhea (2.1%). The freguent physical signs were ascites (93.8%) and abdominal tenderness (45.8%); others were palpable mass (8.3%), hepatomegaly (8.3%), and mild jaundice (4,2%). 3) Hematologic findings in mean value revealed 11.8 g/m% in hemoglobin, 6088/mm in WBC, and 36 mm/hour in ESR, 4) Ascitic analysis revealed 1,031 in specific gravity, 5.2% in protein, and 1700/mm in WBC count with lymphocytic predominance (83%). AFB stain and culture were all negative in the specimens less than 20 ml. 5) On chest X-ray, pulmonary Tuberculosis or associated lesions were noted in 19 patients (39.6%). 6) Studded whitish miliary tubercle, omental change, ad adhesions were noted in a mixed nature. 7) Classifications according to laparoscopic finding revealed wet type in 28 patients (58.3%), mixed type in 13 patients (27.1%), and dry type in 7 patients (14.6%); and laparoscopic type was not related with the duration of symptom up to admission. 8) Microscopic finding of biopsy specimens revealed caseous necrosis or granuloma in 43 patient (89.6%) and nonspecific inflammation in 5 patients. In these 5 patients, characteristic gross findings of tuberculous peritionitis were noted. 9) Intestinal perforation was developed in 2 patients.