Abdominal
tuberculosis (TB) is a rare manifestation, which can be overlooked on long-lasting and non-specific findings unless a high index of suspicion is maintained. The purpose of the present study was to investigate the diagnostic features of 39 patients hospitalized with
tuberculous peritonitis (
TBP) in Dicle University Hospital, Turkey between January 1994 and August 2003. Twenty-two patients were male; patient age ranged between 1 and 59 years (mean: 16.2 +/- 14.4 years). There were 21 patients (54%) under 15 years of age. Thirteen children had a history of familial TB and seven adults had prior history of TB. Six (29%) of 21 pediatric cases had bacille Calmette-Guerin (BCG)
scars and results of 5-tuberculin units (TU)
tuberculin test were positive in seven children (18%). Of all cases, the most common presenting findings were
abdominal pain (95%),
ascites (92%) and abdominal distention (82%). Five of the patients had accompanying pulmonary TB, and six patients (15%) had intestinal TB who were admitted to emergency service with
acute abdomen, of whom three (8%) had perforation and three (8%) had
ileus. Histopathologically 20 cases (51%) were proven on abdominal ultrasonography, and computed tomography revealed most commonly
ascites and thickening of peritoneum. No microbiologic evidence was obtained except three positive culture results for Mycobacterium tuberculosis. As a result,
TBP should be considered for diagnosis, in patients with non-specific symptoms of
abdominal pain, wasting,
fever, loss of appetite, abdominal distension and even symptoms of
acute abdomen, because early diagnosis and effective treatment will decrease morbidity and mortality.