Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis
It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients sus...
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MDPI AG
2023-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/20/3206 |
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| author | Daya K. Jha Pankaj Gupta Pardhu B. Neelam Rajender Kumar Venkata S. Krishnaraju Manish Rohilla Ajay S. Prasad Usha Dutta Vishal Sharma |
| author_facet | Daya K. Jha Pankaj Gupta Pardhu B. Neelam Rajender Kumar Venkata S. Krishnaraju Manish Rohilla Ajay S. Prasad Usha Dutta Vishal Sharma |
| author_sort | Daya K. Jha |
| collection | DOAJ |
| description | It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous peritonitis or peritoneal tuberculosis between Jan 2020 to Dec 2021. The study aimed to identify the clinical and radiological features differentiating the two entities. We included 44 cases of tuberculous peritonitis and 45 cases of peritoneal carcinomatosis, with a median age of 31.5 (23.5–40) and 52 (46–61) years, respectively (<i>p</i> ≤ 0.001). Fever, past history of tuberculosis, and loss of weight were significantly associated with tuberculous peritonitis (<i>p</i> ≤ 0.001, <i>p</i> = 0.038 and <i>p</i> = 0.001). Pain in the abdomen and history of malignancy were significantly associated with peritoneal carcinomatosis (<i>p</i> = 0.038 and <i>p</i> ≤ 0.001). Ascites was the most common radiological finding. Loculated ascites, splenomegaly and conglomeration of lymph nodes predicted tuberculous peritonitis significantly (<i>p</i> ≤ 0.001, <i>p</i> = 0.010, <i>p</i> = 0.038). Focal liver lesion(s) and nodular omental involvement were significantly associated with peritoneal carcinomatosis (<i>p</i> = 0.011, <i>p</i> = 0.029). The use of clinical features in conjunction with radiological findings provide better diagnostic yields because of overlapping imaging findings. |
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| last_indexed | 2024-03-10T21:18:35Z |
| publishDate | 2023-10-01 |
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| series | Diagnostics |
| spelling | doaj.art-5f21cc044b214e3980379e13ad2dc3d02023-11-19T16:12:47ZengMDPI AGDiagnostics2075-44182023-10-011320320610.3390/diagnostics13203206Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal CarcinomatosisDaya K. Jha0Pankaj Gupta1Pardhu B. Neelam2Rajender Kumar3Venkata S. Krishnaraju4Manish Rohilla5Ajay S. Prasad6Usha Dutta7Vishal Sharma8Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Cytopathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Gastroenterology, Army Hospital Research and Referral, New Delhi 110010, IndiaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaDepartment of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaIt is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous peritonitis or peritoneal tuberculosis between Jan 2020 to Dec 2021. The study aimed to identify the clinical and radiological features differentiating the two entities. We included 44 cases of tuberculous peritonitis and 45 cases of peritoneal carcinomatosis, with a median age of 31.5 (23.5–40) and 52 (46–61) years, respectively (<i>p</i> ≤ 0.001). Fever, past history of tuberculosis, and loss of weight were significantly associated with tuberculous peritonitis (<i>p</i> ≤ 0.001, <i>p</i> = 0.038 and <i>p</i> = 0.001). Pain in the abdomen and history of malignancy were significantly associated with peritoneal carcinomatosis (<i>p</i> = 0.038 and <i>p</i> ≤ 0.001). Ascites was the most common radiological finding. Loculated ascites, splenomegaly and conglomeration of lymph nodes predicted tuberculous peritonitis significantly (<i>p</i> ≤ 0.001, <i>p</i> = 0.010, <i>p</i> = 0.038). Focal liver lesion(s) and nodular omental involvement were significantly associated with peritoneal carcinomatosis (<i>p</i> = 0.011, <i>p</i> = 0.029). The use of clinical features in conjunction with radiological findings provide better diagnostic yields because of overlapping imaging findings.https://www.mdpi.com/2075-4418/13/20/3206tuberculous peritonitisabdominal tuberculosisperitoneal tuberculosiscomputed tomographyascitesmalignant ascites |
| spellingShingle | Daya K. Jha Pankaj Gupta Pardhu B. Neelam Rajender Kumar Venkata S. Krishnaraju Manish Rohilla Ajay S. Prasad Usha Dutta Vishal Sharma Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis Diagnostics tuberculous peritonitis abdominal tuberculosis peritoneal tuberculosis computed tomography ascites malignant ascites |
| title | Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis |
| title_full | Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis |
| title_fullStr | Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis |
| title_full_unstemmed | Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis |
| title_short | Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis |
| title_sort | clinical and radiological parameters to discriminate tuberculous peritonitis and peritoneal carcinomatosis |
| topic | tuberculous peritonitis abdominal tuberculosis peritoneal tuberculosis computed tomography ascites malignant ascites |
| url | https://www.mdpi.com/2075-4418/13/20/3206 |
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