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    Evaluation of twenty-seven patients with tuberculous peritonitis
    (A. CARBONE Editore carbone@imd.it, 2016) Kiliç, Murat Özgür; Sağlam, Cemile; Caner, Sevkan Sultan; Kiliç, Yeliz; Içen, Duygu
    Introduction: Tuberculosis (TB) remains a public health problem worldwide. Peritoneal tuberculosis or tuberculous peritonitis (TBP) is an uncommon form of extrapulmonary infection with a proportional increasing of its incidence. This disease is seen most commonly in young adults, and has a highly variable clinical symptomatology. Our aim is to highlight the nonspecific presentation and diagnostic difficulties of the TBP. Materials and methods. We retrospectively reviewed 27 TBP cases diagnosed between 2003 and 2014. Clinical features, all diagnostic methods, and the outcomes of treatment were analyzed in view of literature. Results: Abdominal distension and pain were the most frequent symptoms. A past history of pulmonary TB was obtained in 4 patients. Additionally, concomitant extraperitoneal TB was found in 15 cases. Ascites was the most sonographic finding. Acid-fast staining of ascitic fluid was positive in 1/19. Peritoneal biopsy via laparoscopy or laparotomy was positive for TBP in 13/14. Duration of symptoms prior to diagnosis was found to be associated with prolongation of the treatment (p < 0.001). In addition, pretreatment c-reactive protein was found to be significantly different between the patients requiring a standard therapy of 9 months and the patients requiring additional therapy of 3 months (p=0.023). Conclusion: The diagnosis of TBP is often difficult due to diverse presentation. The patient's anamnesis and the presence of ascites are the most significant marks in diagnosis. Laparoscopy with peritoneal biopsy seems to be the gold standard diagnostic method. © 2018 Elsevier B.V., All rights reserved.