Published: 2021-03-24

Unusual case of tubercular peritonitis

L. Thulasi Devi, Athul R. S.


An interesting case of Pelvic Tubercular Peritonitis, post MTP and IUCD insertion presenting as Severe Sepsis. Managed aggressively with Fluid, supportive measures and complete course of ATT. Case is being reported as an unusual complication post MTP and incidental reports in literature of spread of Pelvic Peritonitis in preexisting Genital Tuberculosis by haematogenous spread.


MTP, IUCD, Pelvic tubercular peritonitis, Severe sepsis

Full Text:



WHO. Global Tuberculosis; 2016. Available at: http://www.who. int/ tb/publications/global_report /en/. Accessed on 15th February 2021.

Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis (Seoul) 2015;78:47-55.

Prevention and control programs. Enferm Infec Microbiol Clin. 2011;29 Suppl 1:2-7.

Sanai FM, Bzeizi KI. Systematic review: Tuberculousperitonitis – Presenting features, diagnostic strategies and treatment.Aliment Pharmacol Ther. 2005;22:685-700.

Kocaman O, Danalioğlu A, İnce AT, Tozlu M, Şentürk H. Diagnosis of tuberculous peritonitis using endoscopic ultrasound-guided fine-needle aspiration biopsy of the peritoneum. Turk J Gastroenterol. 2013;24:65-9.

Khan FY, Al-Muzrakchi AM, Elbedawi MM, Al-Muzrakchi AA, Al Tabeb A. Peritoneal tuberculosis in Qatar: A five-year hospital-based study from 2005 to 2009. Travel Med Infect Dis. 2012;10:25-31.

Manohar A, Simjee AE, Haffejee AA, Pettengell KE. Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period. Gut. 1990;31:1130-2.

El Abkari M, Benajah DA, Aqodad N, Bennouna S, Oudghiri B, Ibrahimi A, et al. Peritoneal tuberculosis in the Fes University Hospital (Morocco). Report of 123 cases. Gastroenterol Clin Biol. 2006;30:377-81.

Sattar Z, Iqbal M, Gondal KM. The frequency of peritoneal tuberculosisusing diagnostic laparoscopy in clinically suspected cases. Ann King Edward Med Univ. 2014;20:176-81.

Makhlouf NA, Makhlouf GA, Soliman A, Sherif MF, Rashed HA. Diagnostic challenges of tuberculosis peritonitis in upper Egypt. Al Azhar Assiut Med J. 2016;14:115-21.

1Dülger AC, Karadaş S, Mete R, Türkdoğan MK, Demirkıran D, Gültepe B, et al. Analysis of cases with tuberculous peritonitis: A single-center experience. Turk J Gastroenterol 2014;25:72-8.

12.Thoreau N, Fain O, Babinet P, Lortholary O, Robineau M, Valeyre D, et al. Peritoneal tuberculosis: 27 cases in the suburbs of Northeastern Paris. Int J Tuberc Lung Dis. 2002;6:253-8.

Cavalli Z, Ader F, Valour F, Saison J, Boussel L, Dumitrescu O, et al. Clinical presentation, diagnosis, and bacterial epidemiology of peritoneal tuberculosis in two university hospitals in France. Infect Dis Ther. 2016;5:193-9.

Chau TN, Leung VK, Wong S, Law ST, Chan WH, Luk IS, et al. Diagnostic challenges of tuberculosis peritonitis in patients with and without end-stage renal failure. Clin Infect Dis 2007;45:141-6.

Vaid U, Kane GC. Tuberculous peritonitis. Microbiol Spectr. 2017;5.

Singh MM, Bhargava AN, Jain KP. Tuberculous peritonitis. An evaluation of pathogenetic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med. 1969;281:1091-4.

Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J Med Res. 2004;120:305-15.

Hanbidge AE, Lynch D, Wilson SR. US of the peritoneum. Radiographics. 2003;23:663‑84.

Tongsong T, Sukpan K, Wanapirak C, Sirichotiyakul S, Tongprasert F. Sonographic features of female pelvic tuberculous peritonitis. J Ultrasound Med. 2007;26:77‑82.

Akhan O, Demirkazik FB, Demirkazik A, Gülekon N, Eryilmaz M, Unsal M, et al. Tuberculous peritonitis: Ultrasonic diagnosis. J Clin Ultrasound 1990;18:711‑4.

Chow KM, Chow VC, Szeto CC. Indication for peritoneal biopsy in tuberculous peritonitis. Am J Surg 2003;185:567‑73.

Abid H, Charif I, Mellouki I, Aqodad D, Benajah A, Ibrahim A, et al. Role of laparoscopy in diagnosis of peritoneal tuberculosis (About 414cases). Open J Gastroenterol. 2013;3:205-7.

Abdelaal A, Alfkey R, Abdelaziem S, Abunada M, Alfaky A, Ibrahim WH, et al. Role of laparoscopic peritoneal biopsy in the diagnosis of peritoneal tuberculosis. A seven year experience. Chirurgia (Bucur) 2014; 109:330 4.

Saxena P, Saxena S. The role of laparoscopy in diagnosis of abdominal tuberculosis. Int Surg J 2016; 3:1557-63.