Clinical and pathological features of three types of peritoneal tuberculosis: a single centre in China

Background: Tuberculosis (TB) is a crucial communicable disease worldwide. Peritoneum tuberculosis (TBP) is a common type of extra-pulmonary tuberculosis. Aim: To investigate clinicopathological features of three different types of TBP. Methods: This retrospective, observational study was conducted from 2009 to 2014 in the hospitalized patients with TBP. Based on the clinical data and surgical records, patients were divided into: wetascitic, fibrotic-fixed, and dry-plastic types. Categorical data were analysed using the Chi-square test or a two-tailed Fisher's exact test. Results: Of the 91 patients (50 male, 41 femalemale to female ratio=1.22) enrolled, 48 (52.7%) were wetascitic, 33 (36.3%) were fibrotic-fixed and 10 (11.0%) were dry-plastic types. The frequency of haematogenous dissemination of pulmonary TB was significantly higher in the dry-plastic type than in fibrotic-fixed type (P=0.0498). The frequency of abdominal pain was significantly lower in the wet-ascitic than in the other two types (P=0.000 and P=0.017). Patients (30 (90.9%)) of fibrotic-fixed type had ileus. The Langhans giant cells were observed more in the wet-ascitic type than in fibrotic-fixed type (P=0.006). All slices in the dry-plastic type were observed with granulomatous inflammation (P=0.040). The hospital stay prolonged in the fibrotic-fixed type and the dry-plastic type than the wet-ascitic type (P=0.006 and P=0.003). Conclusion: The fibrotic-fixed and dry-plastic types TBPs presented more rate of abdominal pain. Most of the fibrotic-fixed type patients have ileus. The Langhans giant cells were observed more in the wetascitic type. All specimens of the dry-plastic type were observed with granulomatous inflammation. All dry-plastic type could be diagnosed through histopathology, but fibrotic-fixed type could not.

[1]  M. Raviglione,et al.  Global Tuberculosis Control: Toward the 2015 Targets and Beyond , 2015, Annals of Internal Medicine.

[2]  Alimuddin Zumla,et al.  The WHO 2014 global tuberculosis report--further to go. , 2015, The Lancet. Global health.

[3]  Hongwei Wang,et al.  Generation of Mycobacterium tuberculosis-specific recombinant antigens and evaluation of the clinical value of antibody detection for serological diagnosis of pulmonary tuberculosis. , 2013, International journal of molecular medicine.

[4]  C. Ng,et al.  Tuberculous peritonitis: analysis of 211 cases in Taiwan. , 2012, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[5]  F. Khan,et al.  Peritoneal tuberculosis in Qatar: a five-year hospital-based study from 2005 to 2009. , 2012, Travel medicine and infectious disease.

[6]  S. Sweetser,et al.  The wet‐ascitic form of tuberculous peritonitis , 2011, Hepatology.

[7]  Surajit Banerjee,et al.  Rapid Identification of Mycobacterium Species with the Aid of Multiplex Polymerase Chain Reaction (PCR) From Clinical Isolates , 2010, The open microbiology journal.

[8]  Cheng-Mao Ho,et al.  Abdominal tuberculosis in adult: 10-year experience in a teaching hospital in central Taiwan. , 2010, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.

[9]  K. Steingart,et al.  A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis , 2007, Thorax.

[10]  D. Chin,et al.  Progress in tuberculosis control and the evolving public-health system in China , 2007, The Lancet.

[11]  D. Çolak,et al.  Evaluation of the ICT Tuberculosis test for the routine diagnosis of tuberculosis , 2006, BMC infectious diseases.

[12]  F. Sanai,et al.  Systematic review: tuberculous peritonitis – presenting features, diagnostic strategies and treatment , 2005, Alimentary pharmacology & therapeutics.

[13]  M. Aldemir,et al.  Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey , 2005, Journal of gastroenterology and hepatology.

[14]  R. Malekzadeh,et al.  Tuberculous peritonitis in an endemic area. , 2003, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[15]  C. Nierhoff,et al.  [Abdominal tuberculosis]. , 2002, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[16]  E. Olcott,et al.  Still the great mimicker: abdominal tuberculosis. , 1997, AJR. American journal of roentgenology.

[17]  P. Kim,et al.  CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. , 1996, AJR. American journal of roentgenology.

[18]  J. Marshall,et al.  Tuberculosis of the gastrointestinal tract and peritoneum. , 1993, The American journal of gastroenterology.

[19]  S. Nijhawan,et al.  Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. , 1992, The American journal of gastroenterology.

[20]  G. M. Aleksandrov [Peritoneal tuberculosis]. , 1952, Fel'dsher i akusherka.