Tuberculous peritonitis in children.

Twelve patients with tuberculous peritonitis were studied. The provisional diagnosis was based on clinical, laboratory and radiological investigations. Later on peritoneoscopy with biopsy established the diagnosis. The presenting symptoms varied and not one symptom or sign was of definite diagnostic significance. Ten of the twelve patients gave a history of exposure to tuberculosis. Ascites was present in three patients, while liver enlargement was observed in seven patients. At the original clinical examination none was diagnosed as tuberculous peritonitis. The results of 5 TU tuberculin test were 10 mm or more in six patients. The chest roentgenogram was abnormal in seven patients, while multiple calcified mesenteric lymph nodes were demonstrated in three patients on the abdominal roentgenogram. Proven sites of tuberculosis besides the tuberculous peritonitis were discovered in seven patients, including pulmonary tuberculosis and tuberculous cervical adenitis. The ascitic fluid studies did not allow a conclusive diagnosis; only one of three ascitic fluid yielded acid-fast bacilli. Peritoneoscopy performed at the same time with peritoneal biopsy seems to be the best approach to establish a definite diagnosis. This disease may easily be overlooked and misdiagnosed, and without specific treatment may give rise to serious complications.