Common symptoms of tuberculous peritonitis

Tuberculous peritonitis is a very common abdominal disease that occurs more often in women. The initial symptoms are generally abdominal distension and pain, fever and sweating, fatigue, lack of energy, etc. This disease is caused by intra-abdominal infection of Mycobacterium tuberculosis. Treatment must be timely and thorough. If not treated in time, other intestinal diseases may easily occur, such as intestinal perforation, etc.

Tuberculous peritonitis varies depending on the pathological type and the body's responsiveness. Generally, the onset is slow and the early symptoms are mild; a few have an acute onset, with acute abdominal pain or sudden high fever as the main clinical manifestations; sometimes the onset is insidious, with no obvious symptoms, and the disease is only discovered accidentally when entering the abdominal cavity during surgery for abdominal diseases unrelated to this disease.

1. Abdominal pain is not obvious in the early stage, but may become persistent dull pain or lack of pain later, or there may be no abdominal pain at all. The pain is mostly located around the navel, lower abdomen, and sometimes throughout the abdomen. In addition to being caused by peritonitis itself, abdominal pain is often related to accompanying active intestinal tuberculosis, mesenteric lymph node tuberculosis or pelvic tuberculosis. When complicated by incomplete intestinal obstruction, there is paroxysmal colic. Occasionally it may present as acute abdomen, which is caused by rupture of caseous necrotic lesions of mesenteric lymph node tuberculosis or other tuberculosis in the abdominal cavity, or by acute perforation of intestinal tuberculosis.

2. Systemic symptoms are common in tuberculosis toxemia, mainly fever and night sweats. The most common fever types are low-grade fever and moderate fever. About 1/3 of patients have remittent fever, and a few may have prolonged fever. High fever accompanied by obvious toxemia is mainly seen in caseous type, exudative type, or in patients with severe tuberculosis such as caseous pneumonia and miliary tuberculosis. In the later stage, malnutrition occurs, manifested as weight loss, anemia, edema, glossitis, angular cheilitis, etc.

3. The softness of the abdominal wall during abdominal palpation is a manifestation of mild irritation or chronic inflammation of the peritoneum, and is a common sign of tuberculous peritonitis. Abdominal tenderness is generally mild; in a few cases, the tenderness is severe and there is rebound tenderness, which is common in caseous tuberculous peritonitis.

4. Ascites often causes a feeling of abdominal distension, which may be caused by tuberculosis viremia or peritonitis accompanied by intestinal dysfunction, and does not necessarily involve ascites.

The ascites in tuberculous peritonitis is mostly small to moderate in amount. A small amount of ascites is difficult to detect in clinical examination, so it must be carefully examined.

5. Abdominal masses are often adhesion-type or caseous-type, often located around the navel but can also be located in other parts of the body. The lumps are mostly composed of enlarged mesenteric lymph nodes, thickened omentum, adhesions of intestinal curves, or accumulations of caseous necrotic purulent substances. They vary in size, have uneven surfaces, and irregular edges. Sometimes it feels nodular. Low activity.

6. Other diarrhea symptoms are common, with mushy stools, usually not exceeding 3 to 4 times a day. Diarrhea has a variety of medical reasons. In addition to intestinal dysfunction caused by peritonitis, it can be caused by intestinal fistula caused by associated ulcerative intestinal tuberculosis or caseous necrotic lesions.

Sometimes diarrhea and constipation alternate, and liver enlargement is not uncommon, which may be caused by fatty liver caused by malnutrition or liver tuberculosis.

The most common complication is intestinal obstruction, which often occurs in the adhesion type. Intestinal fistulas are generally caseous type and are often accompanied by the formation of abdominal abscesses.