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Elusive Diagnosis of Tuberculous Peritonitis

Four patients with tuberculous peritonitis were diagnosed at our hospital in one year. In two patients it was only after surgery for iatrogenic bowel perforation that the diagnosis was made. The difficulty in recognizing this illness in those patients prompted a review of cases in Arkansas over the past nine years. A total of 27 cases have been documented; in 14 the diagnosis was made after considerable delay or during surgery for another diagnosis. Tuberculous peritonitis should be considered in any patient with ascites and chronic abdominal pain.