Abstract
The aim of the research. According to the WHO, the prevalence of respiratory tuberculosis in the world tends to decrease, while the rate of extrapulmonary tuberculosis remains stable: in 2019, approximately 1,050,000 new cases were registered and every sixth of them featured the clinical form of peritonitis. The unsatisfactory results of detection and treatment of tuberculous peritonitis as well as the high frequency of disability and mortality in this disease require a further comprehensive approach to its non-invasive diagnosis including the use of CT. The aim of this study was to evaluate the radiological features of tuberculous peritonitis compared with the data of endoscopic and morphological studies, as well as to develop an optimal integral scale for diagnosis of peritoneal tuberculosis. Material and methods. A retrospective analysis of invasive and CT diagnosis in 25 patients with confirmed tuberculous peritonitis within the period from 2014 to 2020 was performed. The same indicators were used in the comparison group consisting of 28 patients with diseases that often mimic tuberculous peritonitis (by carcinomatosis and sarcoidosis of the peritoneum, non-specific ascites). Results. The main signs of peritoneal lesion in tuberculosis have been revealed. Based on this, an integral scale for assessment of the significance of individual CT symptoms in combination with clinical and anamnestic data has been developed. The statistical data obtained suggest the following pattern: the probability of tuberculous peritonitis upon evaluation of all the described parameters is low with the score of up to 5, and high with 6 or more points. Conclusion. The developed integral scheme for assessment of CT signs allows the clinician to assume the presence of tuberculous peritonitis based on CT scans of the abdominal cavity and chest, anamnesis, as well as the results of laboratory findings, and to choose further tactics in diagnostic search.
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