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Clinical and pathological features of three types of peritoneal tuberculosis: a single centre in China

Background: Tuberculosis (TB) is a crucial communicable disease worldwide. Peritoneum tuberculosis (TBP) is a common type of extra-pulmonary tuberculosis.

Aim: To investigate clinicopathological features of three different types of TBP. Methods: This retrospective, observational study was conducted from 2009 to 2014 in the hospitalized patients with TBP. Based on the clinical data and surgical records, patients were divided into: wetascitic, fibrotic-fixed, and dry-plastic types. Categorical data were analysed using the Chi-square test or a two-tailed Fisher's exact test.

Results: Of the 91 patients (50 male, 41 femalemale to female ratio=1.22) enrolled, 48 (52.7%) were wetascitic, 33 (36.3%) were fibrotic-fixed and 10 (11.0%) were dry-plastic types. The frequency of haematogenous dissemination of pulmonary TB was significantly higher in the dry-plastic type than in fibrotic-fixed type (P=0.0498). The frequency of abdominal pain was significantly lower in the wet-ascitic than in the other two types (P=0.000 and P=0.017). Patients (30 (90.9%)) of fibrotic-fixed type had ileus. The Langhans giant cells were observed more in the wet-ascitic type than in fibrotic-fixed type (P=0.006). All slices in the dry-plastic type were observed with granulomatous inflammation (P=0.040). The hospital stay prolonged in the fibrotic-fixed type and the dry-plastic type than the wet-ascitic type (P=0.006 and P=0.003).

Conclusion: The fibrotic-fixed and dry-plastic types TBPs presented more rate of abdominal pain. Most of the fibrotic-fixed type patients have ileus. The Langhans giant cells were observed more in the wetascitic type. All specimens of the dry-plastic type were observed with granulomatous inflammation. All dry-plastic type could be diagnosed through histopathology, but fibrotic-fixed type could not.

Author(s): Chaohui Zhu, Shuli Liu, Junshan Zhai, Zhi Chen, Kai Wu, Nan Li