The spectrum of tuberculous peritonitis.
The spectrum of tuberculous peritonitis.
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结核性腹膜炎的谱系。
DOI：
10.1378/chest.72.3.310
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发表时间：
1977
期刊：
影响因子：
9.6
通讯作者：
H. N. Beaty
中科院分区：
文献类型：
--
作者：
W. Karney;J. O'donoghue;J. Ostrow;K. Holmes;H. N. Beaty
1966年至1973年，西雅图-金县共收治30例结核性腹膜炎。腹痛、肿胀和躯体症状是最常见的初始主诉。25例患者出现符合结核病的放射学异常，10例患者被证实患有肺部疾病。27例患者中有19例用中等强度的结核菌素纯化蛋白衍生物进行了初步的结核菌素试验呈阴性。在最初的13个非反应堆中，有6个在重复测试中仍然呈阴性反应，在一到四个月后重新测试时，有四个似乎是无能的。30例患者中有67%(20例)有腹水，最常使用剖腹手术来确定诊断。在13名酗酒者中，诊断尤其困难，他们的疾病通常没有被怀疑，腹水中的发现不典型，并且经常出现结核菌素阴性反应。腹膜结核是5例患者的致死原因。其中三名患者也是酗酒者，没有得到诊断和治疗。两名患者死于无关原因。23名患者病情好转，19名患者已完成化疗。
From 1966 to 1973, a total of 30 cases of tuberculous peritonitis were seen in Seattle-King County. Abdominal pain, swelling, and constitutional symptoms were the most frequent initial complaints. Radiographic abnormalities consistent with tuberculosis were present in 25 cases, and pulmonary disease was proven in ten. An initial tuberculin test with intermediate-strength purified protein derivative of tuberculin was negative in 19 of 27 patients. Six of 13 initial nonreactors still had negative reactions on repeat testing, and four appeared to be anergic when retested one to four months later. Ascites was present in 67% (20) of the 30 patients, and laparotomy was used most frequently to establish the diagnosis. Diagnosis was particularly difficult in 13 alcoholics, in whom the disease was usually unsuspected, the findings in the ascitic fluid were uncharacteristic, and negative tuberculin reactions were frequent. Peritoneal tuberculosis was a contributory cause of death in five cases. Three of these patients, who were also alcoholics, went undiagnosed and untreated. Two patients died of unrelated causes. Twenty-three have done well, and 19 have completed chemotherapy.