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View Full Version : T. B. Peritonitis (Etiology-Clinical picture-Investigations-Treatment)



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05-01-2008, 05:52 PM
m Etiology:
1- Extension of infection directly from infected intestine or fallopian tubes (commonest cause).
2- Blood born from distant focus.
m Pathology and Cl. Picture:
Infection may be acute (similar to acute peritonitis) or chronic which may take one of the following:
1- Ascitic type:
- More in children.
- The abdomen is distended with straw coloured effusion.
- The omentum is thickened & rolled up.
2- Encysted type:
- More in young females.
- It gives localized cystic mass d.d. with ovarian cyst..
3- Adhesive type:
- It gives rise to extensive adhesions which may lead to intestinal obstruction.
- External or internal fistulae may result.
- Nodular doughy abdomen is the characteristic sign.
- The omentum may be rolled up and felt above the umbilicus.
m Treatment:
I) Mainly medical treatment of T. B.
II) Surgery is indicated in:
1- Intestinal obstruction. 2- Tense ascitis.
3- Fistulae resisting medical treatment.
4- Encysted type resisting medical treatment.
5- If the 1ry cause was T.B. salpingitis; the tubes & ovary must be removed.
SOURCE: DR. AYMAN SALEM'S BOOK
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