Tüberküloz Peritonit Tanısı ile Takip Edilen Olguların Değerlendirilmesi
Amaç: Son yıllarda ekstrapulmoner tüberküloz olgularının arttığı gözlenmektedir. Tüberküloz peritonit nadir görülen ekstrapulmoner tüberküloz formudur. Bu çalışmada tüberküloz peritonit olgularını irdeledik.
Yöntem: Bu çalışma, Ocak 2012-Şubat 2020 tarihleri arasında hastanemizde tüberküloz peritonit tanısıyla takip edilen toplam 23 hastanın verisini içeren retrospektif bir çalışmadır. Veriler hasta dosyalarından, hastane veri kayıt sisteminden elde edilmiştir.
Bulgular: Hastaların 8 (%34.8)’i erkek, 15 (%65.2)’i kadın, yaş ortalaması 41,5±22.1 idi. Beş (%21.7) hastada hipertansiyon, 3 (%13)’ünde diyabetes mellitus mevcuttu. Hastaların 20 (%87)’sinde karın ağrısı, 18 (%78.3)’inde ateş, karında şişlik ve asit, 17 (%73.9)’sinde gece terlemesi, 14 (%60.9)’ünde iştahsızlık mevcuttu. Onaltı (%69.5) hastada radyolojik yöntem olarak bilgisayarlı tomografi ve ultrasonografi, 7 (%30.5) hastada sadece bilgisayarlı tomografi kullanıldı. Hastaların 17 (%73.9)’sinde tanı histopatolojik, 3 (%13)’ünde mikrobiyolojik, 3 (%13)’ünde ise hem mikrobiyolojik hem histopatolojik olarak konuldu.
Sonuç: Tüberküloz peritonitte erken tedavi önemli olduğundan en kısa sürede tanıya gidilmelidir. Radyolojik bulgular nonspesifik olmakla beraber tanıda yardımcıdır. Hem düşündürücü bulgular olması hem de asit sıvısı ve periton incelemesi için ultrasonografi ve bilgisayarlı tomografi oldukça yol göstericidir.
Evaluation of Patients Followed with Diagnosis of Tuberculosis Peritonitis
Aim: In recent years, it has been observed that extrapulmonary tuberculosis cases have increased compared to pulmonary tuberculosis cases. In patients with pulmonary tuberculosis, extra pulmonary tuberculosis is asymptomatic, although the true incidence of intraabdominal and gastrointestinal tuberculosis is unknown, there are studies reporting that tuberculous peri- tonitis is rare. Radiology guides the diagnosis of this disease, which can be missed and has increased morbidity and mortality when early diagnosis is not made. In this study, we aimed to examine our patients with tuberculous peritonitis with epidemiological, clinical and laboratory findings and to emphasize that radiology is a guide in diagnosis.
Methods: This is a retrospective study including epidemiological, clinical and laboratory data of 23 patients who were followed up with the diagnosis of tuberculous peritonitis in our hospital between January 2012 and February 2020. The data were obtained from patient files and hospital data recording system. The data obtained were evaluated using numbers and percentage calculation.
Results: 8 (34.8%) of the patients were male, 15 (65.2%) were female, the mean age was 41.5 ± 22.1. Five (21.7%) patients had hypertension and 3 (13%) had diabetes mellitus. 20 (87%) of the patients had abdominal pain, 18 (78.3%) had fever, abdominal swelling and acid, 17 (73.9%) had night sweats, and 14 (60.9%) had anorexia. Computed tomography and ultrasonograp- hy were used as radiological methods in 16 (69.5%) patients, and only computed tomography was used in 7 (30.5%) patients. The diagnosis was made histopathologically in 17 (73.9%) of the patients, microbiological in 3 (13%), and both microbiological and histopathologically in 3 (13%) patients.
Conclusion: Tuberculous peritonitis is a rare disease that can be easily overlooked because its signs and symptoms are nonspecific. Early diagnosis and treatment is important to prevent morbidity and mortality. The radiological findings are very helpful in diagnosis. Ultrasonography and computed tomography are very guiding both for the diagnosis of tuberculous peritonitis and for the examination of acid fluid and peritoneum.
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- Uzunköy A, Nazlıgül Y. Tüberküloz Peritonit. Turkiye Klinikleri J Med Sci 2006; 26:404-408
- Demirkazık FB, Akhan O, Özmen MN, ve ark. US and CT findings in the diagnosis of tuberculous peritonitis. Acta Radiol 1996; 100 (2): 517- 20.
