Tuberculose périfonéale dans un service de médecine interne en milieu tropical: aspects clinique, biologique et laparoscopique Bamako — Mali
Peritoneal tuberculosis in an internal medicine service in a tropical setting: clinical, biological and laparoscopic aspects in Bamako, Mali
The objectives of our retrospective study were to determine peritoneal tuberculosis frequency, to describe its laparoscopic and clinical manifestations and the characteristics of the ascitis fluid.
The included patients recorded forms were those presenting granulations and/or peritoneal nodules at laparoscopy. In all cases, the anatomical and pathological examination of these lesions confirmed the diagnosis of peritoneal tuberculosis. Twenty-six patients were included in the study: 10 men and 16 women.
Peritoneal tuberculosis occurred in 4.13 % of the tuberculosis total case. The mean age was 37.7 ±15 years from 12 to 65 years. The most important clinical signs were ascitis (88.5 %), weight loss (53,8 %), anorexia (53.8 %), abdominal pain (42.2 %), asthenia (42.3 %) and fever (42.3 %).
The association of granulations and nodules was the most laparoscopically frequent abnormality: 80.76 % (21/26). The direct examination with Ziehl Neelson coloration and the bacillus of Koch (BK) culture in Lowenstein media were positive in 50 % (3/6) et 60 % (3/5) respectively.
In Africa, laparoscopy remains an examination of choice for the diagnostic of peritoneal tuberculosis. It allows the discovery of granulations: classical lesions but also peritoneal nodules that could be discussed as peritoneal metastasis.
M. DEMBELE, M.Y. MAIGA, D.K. MINTA, Sidibe A. TRAORE, M. SACKO, A.K. TRAORE, A.H. CISSE, C.T. DIOP, M. BABY, A.I. BOCOUM, S. FONGORO, D. DIALLO, H.A. TRAORE
Bamako, laparoscopy, Mali, nodules, peritoneal tuberculosis