Is There a Role of Lavage in Peritoneal Tuberculosis?

Abstract

Abdominal tuberculosis (TB), an extrapulmonary manifestation of TB, can present with nonspecific symptoms that may resemble an acute surgical abdomen or abdominal malignancy. Peritoneal tuberculosis/TB peritonitis, typically manifests with abdominal pain, abdominal distension (possibly due to ascites), weight loss, and night sweats. We present two cases of peritoneal TB where patients exhibited abdominal distension and weight loss with features suggestive of intestinal obstruction or an abdominal malignancy. They were initially treated with standard anti-TB medication (RHZE regimen), but showed no improvement. However, after undergoing laparotomy and lavage, resulting in reduced focus of infection, they responded well to the 6-month course of anti-TB medication. The current management approach for abdominal TB recommends a 6-month regimen of anti-TB medication. Despite the lack of initial response to anti-TB medication, the substantial improvement observed when initiating anti-TB treatment after peritoneal lavage indicates its potential benefit in such patients. Further research is needed to explore this question.

Keywords

• drainage
• lavage
• tb peritonitis