Prevalence of tuberculous peritonitis in the North of Iraq and sociodemographic comparison with pulmonary tubercu-losis

• Published in: 亚太热带医药杂志（英文版） no. 2; pp. 58 - 63
• Main Authors: Abdulqadir Maghded Zangana, Tariq SAl-Hadithi MSc, Sherzad Ali Ismail
• Format: Journal Article
• Language: English
• Published: Department of Surgery, College ofMedicine,Hawler Medical University Erbil,Iraq%Department of Community and Tropical Medicine, College ofMedicine,Hawler Medical University Erbil,Iraq%Department ofCommunity Medicine, College ofMedicine,Hawler Medical University Erbil,Iraq 2009
• Subjects: Tuberculous peritonitis; Treatment outcome; Pulmonary tuberculosis; Laparoscopy; Laparotomy
• ISSN: 1995-7645

Objective:Tuberculosis continues to be an important health problem in the world.Despite the widespread im-pression that abdominal tuberculosis is rare today,the disease is still endemic in developing world and is re-emerging in the West.The aim is to review our local experience with tuberculous peritonitis.Methods:Be-tween January 2000 and December 2006,the case records of histologically documented tuberculous peritonitis (TBP)diagnosed and treated at the tuberculosis coordinating center in Erbil city,Iraq were reviewed.Com-parisons were made with pulmonary tuberculosis patients regarding socio-demographic,clinical and laboratory findings.Results:Forty one cases of TBP were diagnosed during the study period.Their age range was 26-72 years (46 ±17),with a male:female ratio of 1.5:1.The median duration of symptoms before diagnosis was 6 weeks (range:10 days to 18 months.).Eleven patients (26.8%)had comorbid conditions and 6 patients (14.6%)had a history of positive contact with Tuberculosis(TB)case.Presenting symptoms were abdominal distension (70%),abdominal pain (65%),fever (68%),anorexia (65%)and weight loss (44%).Four patients had pulmonary symptoms:cough and /dyspnoea (n =2)and cough (n =2).Chest X-ray changes consistent with pulmonary tuberulosis(PTB)were seen in 25%.Tuberculous peritonitis was diagnosed by lap-aroscopy (n =29)and laparotomy (n =12).Adverse effects of TB drugs occurred in nearly 40%,consisting of hepatitis (n =2),nausea /vomiting (n =11),rash (n =2)and encephalopathy (n =1).Hemoglobin and serum albumin levels were significantly lower in tuberculous peritonitis(TBP)TBP patients (P =0.027 and 0. 003,respectively).There was a significantly greater occurrence of adverse effects (P <0.001)in TBP pa-tients.No significant differences between TBP and PTB were demonstrated in regard to age and sex distribu-tion,non-specific symptoms (fever,weight loss,and anorexia)and erythrocyte sedimentation rate.All were treated with standard regimens and responded to treatment.Conclusion:Tuberculous peritonitis is prevalent in our population.Therefore,TBP should be considered in patients presenting with abdominal symptoms and non-specific constitutional symptoms,particularly in young patients.Laparoscopy and laparotomy with tissue biopsy was the specific diagnostic procedure.