Thoreau N, Fain O, Babinet P, Lortholary O, Robineau M, Valeyre D, Boudon P, Desrues J, Glowinski J, Mechali D, Poirier C, Joudiou P, Rautureau J, Stirnemann J, Kettaneh A, Cruaud P, Thomas M
Service de Médecine Interne, de Maladies Infectieuses, Hôpital Delafontaine, Saint-Denis, France.
Int J Tuberc Lung Dis. 2002 Mar;6(3):253-8.
Peritoneal tuberculosis did not disappear from France during the 1990s.
To determine the characteristics of peritoneal tuberculosis in the north-eastern suburbs of Paris.
A retrospective study of cases diagnosed with peritoneal tuberculosis between 1990 and 1998 in five suburban hospitals in the north-east region of Paris.
Twenty-seven cases of adult peritoneal tuberculosis were diagnosed. There were nine women and 18 men, with a mean age of 37.5 years, 88.9% of whom were foreign born. General and digestive symptoms--abdominal pain and/or ascites--were present in 96.3% of the cases. The mean delay in treatment was 30 days. Peritoneal involvement was isolated in 25.9% of cases, and associated with pulmonary tuberculosis in 40.7% or hepatic tuberculosis in 25.9%. Co-infection with HIV (human immunodeficiency virus) was present 14.8% of cases. Culture of ascites fluid, laparoscopy and/or laparotomy (n = 17), with directed biopsy, aided in the formal diagnosis of peritoneal tuberculosis in 59.2%. One relapse and one case of multiresistance were observed. The mean duration of treatment was 9 months (range 6-12 months). Three patients received treatment with corticosteroids, and 91.2% of the patients achieved cure without sequelae.
Peritoneal tuberculosis is not rare in the Paris region. The diagnosis should be suspected in case with ascites and fever, and can be confirmed by laparoscopy with sampling for bacteriology and histology. The methods of treatment need to be standardised.
20世纪90年代，腹膜结核在法国并未消失。
确定巴黎东北郊区腹膜结核的特征。
对1990年至1998年期间在巴黎东北地区五家郊区医院诊断为腹膜结核的病例进行回顾性研究。
确诊27例成人腹膜结核病例。其中女性9例，男性18例，平均年龄37.5岁，88.9%为出生在国外者。96.3%的病例出现全身和消化系统症状——腹痛和/或腹水。平均治疗延迟时间为30天。25.9%的病例为孤立性腹膜受累，40.7%与肺结核相关，25.9%与肝结核相关。14.8%的病例合并感染HIV（人类免疫缺陷病毒）。腹水培养、腹腔镜检查和/或剖腹手术（n = 17）并进行定向活检，使59.2%的病例得以正式诊断为腹膜结核。观察到1例复发和1例多重耐药病例。平均治疗持续时间为9个月（范围6 - 12个月）。3例患者接受了皮质类固醇治疗，91.2%的患者治愈且无后遗症。
腹膜结核在巴黎地区并不罕见。对于有腹水和发热的病例应怀疑该病，可通过腹腔镜检查并进行细菌学和组织学取样来确诊。治疗方法需要标准化。
