• Vol. 34 No. 9, 548–552
  • 15 October 2005

Tuberculosis Peritonitis in Negara Brunei Darussalam



Introduction: Tuberculosis peritonitis (TBP) is uncommon and symptoms can be non-specific. Local data are lacking and our aim is to review our local experience with TBP. Materials and Methods: Between the period of 1996 to 2004, there were 10 [male: 6; mean age, 48 ± 18.5 years (range, 26 to 73)] cases of histologically documented TBP. Comparisons were made with pulmonary tuberculosis (PTB) patients. Results: The overall prevalence ranged from 0% to 1.01% of all TB infections. The median duration of symptoms before diagnosis was 2 months (range, 3 days to 24 months). Five patients (50%) had comorbid conditions and 3 patients (30%) had a history of positive contact. Presenting symptoms were abdominal distension (70%), abdominal pain (60%), fever (60%), anorexia (60%) and weight loss (40%). Two patients had pulmonary symptoms: cough/dyspnoea (n = 1) and cough (n = 1). Chest x-ray changes consistent with PTB were seen in 30%. TBP was diagnosed by laparoscopy (n = 6), laparotomy (n = 3) and blind peritoneal biopsy (n = 1). Adverse effects of TB drugs occurred in 80%, consisting of hepatitis (n = 4), nausea/vomiting (n = 2), rash (n = 1) and encephalopathy (n = 1). Haemoglobin (P = 0.026) and serum albumin levels (P = 0.002) were significantly lower in TBP patients. There was a significantly greater number of adverse effects (P <0.001). There were no significant differences between TBP and PTB with regard to age, non-specific symptoms (weight loss, anorexia and fever) and erythrocyte sedimentation rate. All were treated with standard regimes and there were no mortalities. Conclusions: TBP is uncommon in our population. TBP patients had significantly lower haemoglobin and serum albumin levels. They also experienced more adverse events during treatment. There were no differences in non-specific symptoms between TBP and PTB.

There has been a resurgence of tuberculosis (TB) in many countries, including developed nations, especially with the HIV pandemic and the increase in immigration.1,2 In underdeveloped and developing nations, this infectious disease is still very common. TB peritonitis (TBP) is rarely encountered and is estimated to occur in 0.1% to 3.5% of those with active pulmonary TB (PTB) and represents 4% to 10% of all extrapulmonary TB.1 TBP, like TB infections involving other organs, is easily treated. However, it is often misdiagnosed as carcinomatosis peritonitis or diagnosed at a later stage, leading to a delay in treatment or inappropriate treatment.3,4 This can lead to significant morbidity and even mortality.5-7 We present a review of the local experience with TBP, looking at the clinical characteristics, investigations and treatment outcomes. Comparisons were made with PTB patients.

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