Clinico-radiological Classification of Peritoneal Tuberculosis
Clinico-radiological Classification of Peritoneal Tuberculosis
Traditionally, peritoneal tuberculosis has been classified as wet-ascitic, dry-plastic type
 and fibrotic -fixed types. there is substantial overlap between these definitions and the
 clinical implication of the categorisation into the three patterns is unclear.

 The clinical presentation will be used to divide participants into 1) Abdominal distension
 dominant disease or 2) Pain Dominant and/or 3) Obstruction dominant peritoneal tuberculosis.
 The radiological findings between these groups will be compared if findings on radiology are
 discriminative of these three patterns of presentation.
The study will be conducted as two parts

 1. Derivation group:

 Screening population: Patients with abdominal tuberculosis treated in the
 gastroenterology unit from Jan 2017-Dec 2018 This will involve a retrospective study
 where the patients who have been treated for peritoneal tuberculosis and have full
 records available (as hospital records or Gut-Tuberculosis clinic files) will be
 included and their clinical details and radiological findings (from CT films or images)
 will be entered and compared. The radiological findings between these groups will be
 compared if findings on radiology are discriminative of these three patterns of
 presentation.

 2. Validation Study: This will include prospective study of patients who have underwent
 computed tomography for evaluation of abdominal complaints and are eventually diagnosed
 to have peritoneal tuberculosis. The radiological parameters derived from the derivation
 group will be tested to predict the clinical presentation.

 At the end of the study,the feasibility of a clinico-radiological classification of
 peritoneal tuberculosis.

 The clinical details will be recorded and will include demographic details, diagnostic
 work-up (confirmed/probable), follow-up and classification into one of the three patterns of
 presentation

 1. Distension dominant: Presence of abdominal distention or discomfort, Lack of pain

 2. Pain dominant: Patients having associated significant abdominal pain necessitating
 analgesics or interfering with routine activities

 3. Obstruction dominant; Clear historical and/or radiological evidence of intestinal
 obstruction like abdominal pain associated with distension and obstipation

 Computed tomographic scans/images will be assessed by the two radiologists separately and
 resolved by consensus The radiologists will not have access to any clinical details The
 findings will be recorded on a proforma and will include determination of presence and extent
 of ascites, loculated ascites, peritoneal nodules or masses, omental involvement as nodules
 or masses, mesenteric adenopathy, masses, abdominal lymphadenopathy, presence of clumped
 loops, adhesions, abdominal cocoon etc The three groups will be compared for these
 radiological patterns and a possible correlation between any radiological findings and the
 clinical presentation will be derived.

 The classification derived from the derivation cohort will be tested in validation cohort
 which will be a prospective study. The clinical presentation will be recorded. The CT scans
 will be reviewed by two radiologists blinded to clinical details and the clinical
 presentation will be compared with categorisation based on the radiological findings.
Inclusion Criteria

 -  Patients diagnosed with peritoneal tuberculosis

 -  Patients who have undergone a computed tomographic examination

 Exclusion Criteria:

 -  Age < 12

 -  Unclear diagnosis

 -  More than one etiology for ascites

 -  Not willing for consent