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[Tuberculous encapsulating peritonitis. About 18 cases].

La Tunisie Médicale 2005 November
Our goal is to study the circumstances of diagnosis and the therapeutic modes of encapsulating peritonitis of tubercular origin. We report in this retrospective study 18 cases of encapsulating peritonitis of tubercular origin collected from 1982 to 2000. Symptoms and signs ere dominated by the general signs of tubercular nature, found isolated or in association with other, in 14 patients. Abdominal pain was found in all patients. Gastrointestinal disorders were found in 11 patients. A typically sound abdominal mass was found in 3 cases. The ultrasonographic data associated with the biologic data, helped in making the diagnosis. Confirmation of the tubercular origin was provided by histological examination of the biopsies. Treatment was based on the anti-tuberculosis chemotherapy associating four antituberculous drugs taken daily during two months replated by the association of two antituberculous drugs during a period of six to 13 months. The outcome was favourable in 16 patients but the two patientsdied. Histological diagnosis and more rarely bacteriological examination, would be essential in order to start an early treatment. This diagnosis is confirmed by open coelioscopy when the ascitis is septated or by exploratory laparotomy in the fibro-adhesive formes. Radical surgery is indicated in case of complications.

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