TUBERCULOUS PERITONITIS: EFFECTIVENESS OF ULTRASONOGRAPHY IN DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

Peritonitis tüberkülozun nadir görülen bir þeklidir. Bu çalýþmada tüberküloz peritonitin ultrasonografýk bulgularýnýn deðerlendirilmesi amaçlandý. Karýn aðrýsý, karýnda þiþlik, ateþ ve kilo kaybý yakýnmalarýyla müracaat eden altý olgu prospektif olarak incelendi. Sonografýk incelemede olgularýn tamamýnda asit saptandý. Üç olguda homojen anekoik görünüm, iki olguda asit içinde ekojen yýkýntý ürünleri vardý. Yaygýn asitli olgularda fibröz septalar ve dört olguda ince inkomplet mobil bantlar saptandý. Üç hastada peritoneal yüzeyde nodülerite izlendi. Olgularýn üçünde omental kalýnlaþmayý teyit eden omental kek bulgusu saptandý. Lokalize veya yaygýn asitin, septasyon ve internal ekolarýn, peritoneal kalýnlaþma ve nodüleritenin tespitinin þiddetle tüberküloz peritoniti düþündürebileceði, ultrasonografinin tanýda önemli bir rol oynadýðý ve böylece hastalarýn laparoskopi ve laparotomi gibi daha invaziv yöntemlerden korunabileceði kanýsýna verildi.

TUBERCULOUS PERITONITIS: EFFECTIVENESS OF ULTRASONOGRAPHY IN DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

Peritonitis is a rare form of tuberculosis. The evaluation of the ultrasonographic findings in tuberculous peritonitis was intended in this study. Six cases who referred to the hospital suffering from abdominal pain, abdominal swelling, fever and weight loss were evaluated by ultrasonography prospectively. Ascites was found in all cases by sonographic examination. Homogenous anechoic appearance in three and echogenic debris in the ascites in two cases were present. Fibrous septates were detected in cases with disseminated ascites and fine, incomplete mobile strands in four of cases. Nodularity was observed on the peritoneal surface in three patients. In three cases, omental cake sign which confirms the omental thickening was detected. It is concluded that localized or diffuse ascites, septations and internal echoes, peritoneal thickening and nodularity, may strongly suggest tuberculous peritonitis, and ultrasonography plays an important role in the diagnosis, and prevents further invasive interventions such as peritoneoscopy and laparotomi.