Background. Due to the fact that inflammatory bowel diseases (IBD) are widespread among the population, the development of new drugs for the treatment of IBD is a public health priority. Preclinical drug testing is inextricably linked with the modeling of IBD in laboratory animals. This study purpose was to develop a model of chemically induced colitis in rabbits. Methods. The study was performed on male rabbits of the “Soviet Chinchilla” breed. Colitis was simulated by oral administration of dextran sulfate sodium (DSS) in a concentration of 0.1% to 2% solution for five consecutive days. Euthanasia of laboratory animals was carried out on the seventh day, after the end of taking the DSS solution. A histological examination of the intestine was performed. Results. It was found that using 0.1% DSS solution allows to obtain a model of mild erosive colitis. The use of 0.5% DSS solution gave the intermediate severity of erosive ulcerative colitis. DSS concentration of more than 1% led to the development of severe ulcerative colitis in rabbits and the death rate of 71.4% among them. Conclusion. The obtained results indicate that the use of 0.5% DSS solution makes it possible to create a model of erosive ulcerative colitis in rabbits suitable for studying human IBD.

This article demonstrates the possibilities of vacuum-assisted closure (VAC therapy) in surgical treatment of one of the most severe categories of patients — patients with chronic pulmonary tuberculosis with widespread drug resistance. The authors show the effectiveness of VAC therapy in various clinical situations: VAC therapy in combination with endoscopic valvular bronchoblocation, as an independent treatment method in a patient with bilateral fibrous-cavernous pulmonary tuberculosis, as well as a combination of VAC therapy with retrograde occlusion of bronchial fistula. The special feature of these cases is the performance of low-trauma organ-preserving operations in patients with no prospect of cure by conservative methods.

The objective: to evaluate VTEC in new tuberculosis patients and relapses, to determine main factors influencing its development (according to data of the patients admitted to Moscow tuberculosis hospitals)Subjects and Methods. Based on the data of epidemiological tuberculosis monitoring system of Moscow, treatment outcomes of 4609 tuberculosis patients admitted to tuberculosis hospitals from 2020 to 2022 were retrospectively analyzed. The incidence of VTEC was estimated.Results. Totally 214/4609 cases of VTEC were identified (4.6%; 95% CI 4.1-5.3%), among which the incidence of DVT made 3.5% (95% CI 3.0-4.1%), SVP 1.5% (95% CI 1.2-1.9%), and PATE 0.6% (95% CI 0.4-0.8%). The most significant risk factors of thrombotic complications in tuberculosis patients were identified, those factors included HIV infection (RR 3.8; 95% CI 2.7-4.5) and fibrous cavernous form of pulmonary tuberculosis (RR 9.1; 95% CI 4.7-17.6). The overall prevalence of VTEC in tuberculosis hospitals was 3 or more times higher than in general clinics (according to the published data).Conclusion. The data obtained indicate that patients hospitalized for pulmonary tuberculosis face a high risk of VTEC development that requires prediction and prevention.

Venous thromboembolic complications (VTEC) haven’t lost their status as an important medical and social problem for many decades. There are about 300 thousand people die from VTEC in Russia every year. Another significant problem for our country is tuberculosis. Tuberculosis is one of the most common severe infections in the world, most often occurs as a chronic disease and can induce VTEC due to a variety of synergistically acting factors. Previously published studies examined the interaction between tuberculosis and VTEC, but they were based on the data obtained from countries with a high incidence of tuberculosis and a low prevalence of venous thrombosis. An analysis of the literature has shown that tuberculous inflammation determines all three interrelated components of the Virchow’s triad: endothelium inflammatory damage, venous stasis and hypercoagulability. In addition, treatment regimens for the disease with the inclusion of rifampicin also contribute to the development of VTEC due to the pronounced procoagulant properties of the drug. Another equally important agent that potentiates hypercoagulation is the HIV virus, which affects the endothelium and immunocompetent cells. Currently available epidemiological data indicate that HIV infection is associated with an increased risk of VTEC in 2-10 times compared to the general population of the same age. In this context, tuberculosis and HIV/TB co-infection can be considered as a large reversible risk factor for the development of VTEC and included in the prognostic risk assessment scales for acute venous thrombosis and embolism.

Introduction. Acute pancreatitis is common in HIV-infected patients and has a number of significant features that directly affect the methods of diagnosis and treatment. Aim. To study risk factors of acute pancreatitis development in patients with HIV-infection with immunosuppressive disorders and to determine treatment and diagnostic algorithm in this group of patients. Material and Methods. Anamnestic data, results of diagnosis and treatment of two groups of patients with acute pancreatitis were analyzed. The first group included 79 patients with acute pancreatitis combined with HIV infection who were admitted to the clinic for the period from 2017 to 2021. The second group consisted of 558 HIV-negative patients with acute pancreatitis. Results and discussion. In the group of HIV-positive patients it turned out that alimentary factors caused pancreatitis in 31,7% of patients, biliary concretions and hypertension in 16,5% of patients, it was not possible to establish an initiating factor of the disease in 16,5% of cases. In people living with HIV drugs and infectious agents caused acute pancreatitis in 11,4% and 24,1% of cases respectively. Alimentary factors were in the lead in the group of HIV–negative patients (52,2%), gallstone disease was considered as the second main cause of pancreatitis – 36,0% of cases, viral infections and the consequences of the use of drugs respectively accounted for 1,6%, and in 10,2% of patients the cause of acute pancreatitis remained unknown. Discussion. As our study showed, in patients with normal immune status the drug etiology of pancreatitis prevailed in the structure of the causes of pancreatitis, in patients with immunodeficiency, respectively, infectious causes of pancreatitis were dominant. Based on the obtained data on the cause of pancreatitis, the rational therapeutic and diagnostic algorithm was formed, the use of which in clinical practice will allow timely initiation of etiotropic and pathogenetic therapy in a group of HIV- positive patients. Conclusion. The etiological structure of HIV-associated acute pancreatitis directly depends on the patient’s immune status and differs in many ways from that of HIV-negative patients or patients receiving antiretroviral therapy. The severity of the disease and the risk of death remain high in acute pancreatitis caused by infectious agents against the background of immunosuppression.

The objective : to assess the incidence of tuberculous peritonitis, to identify its gender and age characteristics, to describe typical comorbidities preceding the development of peritoneal tuberculosis. Subjects and Methods . The following documents were statistically analyzed: Forms no. 003/u Medical Record of an In-patient Patient for new tuberculous peritonitis patients for 2013–2020, who were treated at Clinic 2 of Moscow Municipal Scientific Practical Center of Tuberculosis Control, Moscow Health Department, and Rosstat Forms No. 8 on Active Tuberculosis Cases for the same period, as well as information from registers of the city tuberculosis monitoring system that has been operating in Moscow since 1996. Results. According to different definitions, the expected incidence of tuberculous peritonitis in the coming years will make from 0.03 to 0.1 per 100,000 population per year in Moscow and 0.1–0.2 per 100,000 in Russia. In Moscow, the main cohort of tuberculous peritonitis patients includes young women after pregnancy and childbirth, who came from other regions of the Russian Federation or neighboring countries. Men develop tuberculous peritonitis 1.6 times less frequently versus women. The most common factors influencing the development of peritoneal tuberculosis in men are drug-induced immunosuppression, dialysis, and diabetes mellitus. HIV infection, unlike other forms of extrapulmonary tuberculosis, is not a major risk factor faced by individuals with tuberculous peritonitis.

Background. Urethral strictures are currently one of the most complex pathologies in reconstructive urology. The most promising direction in this area is the development of single-stage surgical interventions that meets modern requirements for the quality of life of patients.The aim of the study. To evaluate the possibility and the effectiveness of surgical treatment of extended recurrent tuberculous urethral strictures in men using a combination of a skin flap and a buccal graft. In the literature, there is no description of the use of this technique in patients with urethral tuberculosis.Materials and methods. We observed 44 patients with urethral tuberculosis. Three men from this group of patients were diagnosed with tuberculous (post-tuberculous) extended recurrent stricture of the anterior urethra and they underwent combined single-stage urethroplasty with a ventral fasciocutaneous flap and a buccal graft using the inlay method in the penile region and with a buccal graft using the ventral onlay method in the bulbous urethra. Ultrasound of the urethra served as a method that determines the possibility of performing this surgery in case of maintaining a sufficient width of the urethral plate with a moderate degree of spongiofibrosis.Results. Patients were under observation for 34, 50 and 54 months and have good long-term functional results – all patients have unassisted urination and no residual urine. Post-micturition dribbling persists in 1 patient. The overall effectiveness of the treatment of these strictures, taking into account the treatment of repeated cases of the disease recurrence, is high.Conclusion. This technique demonstrates the possibility of performing a single-stage reconstruction of the anterior urethra in patients with extended recurrent tuberculous (post-tuberculous) urethral strictures and is also applicable for the surgical treatment of urethral strictures of other origins.

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.

The objective: to create a reproducible model of chronic tuberculosis peritonitis to study pathophysiological mechanisms of its progression and to develop pathogenetically based therapy.Subjects and Methods. The study was performed using 10 male rabbits of the Chinchilla breed. The animals were administered intraperitoneal culture of Mycobacterium tuberculosis, tuberculosis peritonitis modeling was performed according to the proposed method.Results. In the course of the experiment, it was proved that all animals developed tuberculous peritonitis with lesions of the large omentum and serous integuments of internal organs. Molecular genetic tests of fragments of the omentum and peritoneum detected DNA of Mycobacterium tuberculosis.

The prevalence of tuberculous peritonitis that has been observed in the recent decades is the result of lymphohematogenous spread of Mycobacterium tuberculosis (MBT) from lungs and other extrapulmonary sources. It is still unclear why certain organs and anatomical regions get involved in the inflammatory process during generalization of the tuberculosis infection. Why do some cases develop into peritoneal tuberculosis and other into kidney tuberculosis? Thus study aimed to investigate the pathogenesis of tuberculous peritonitis in a reproducible biological model. Tuberculous peritonitis was modeled in 18 rabbits (10 in the test group, 8 in control) by intraperitoneal inoculation of the MBT suspension. In order to suppress peritoneal macrophages and major cytokines, test group rabbits were injected with the TNFα inhibitor and iron (III) hydroxide sucrose complex before being infected, while control group rabbits received no immunosuppressive drugs. Autopsy of the control group animals revealed changes characteristic of pulmonary tuberculosis in 37.5% of cases, with no damage to other organs and systems registered. Conversely, test group rabbits had the signs of tuberculous peritonitis in their abdominal cavities. The results of this study suggest that it is the local immunity of an anatomical area that largely determines whether a secondary focus of extrapulmonary tuberculosis infection will develop there or not. For the peritoneum, a smaller pool of peritoneal macrophages and weaker cytokine production is a necessary and sufficient condition to have tuberculous peritonitis developing therein.

Dvojnoe bremya novoj koronavirusnoj infekcii COVID-19 i tuberkuleza yavlyaetsya odnoj iz global'nyh problem segodnyashnego dnya. Malo izucheny osobennosti okazaniya ekstrennoj hirurgicheskoj pomoshchi etomu kontingentu pacientov. Cel'yu issledovaniya bylo ocenit' rezul'taty lecheniya ostroj hirurgicheskoj patologii u pacientov s novoj koronavirusnoj infekciej COVID-19 v sochetanii s tuberkulezom. Za 2020 g. prolecheno 465 pacientov s sochetannoj infekciej COVID-19/tuberkulez, pri etom ekstrennaya hirurgicheskaya pomoshch' potrebovalas' v 36 (5,6%) sluchayah, v tom chisle 16 pacientam s VICH-infekciej, kotorym vypolneno 64 ekstrennyh operativnyh vmeshatel'stva. Tuberkulez organov dyhaniya vyyavlen u 13 (36,1%) bol'nyh, generalizovannyj — u 23 (63,9%). Po dannym komp'yuternoj tomografii (KT) organov grudnoj kletki ob"em vovlecheniya legochnoj tkani pri virusnoj pnevmonii COVID-19 menee 25% zaregistrirovan u 61,9% bol'nyh, 25–50% — u 30,6%, 50–75% — u 5,6%. KT organov bryushnoj polosti pozvolila vyyavit' oslozhneniya adbominal'nogo tuberkuleza (perforacii tuberkuleznyh yazv kishechnika, ostruyu kishechnuyu neprohodimost', tuberkuleznyj peritonit), tuberkuleznyj spondilit, oslozhnennyj psoas-abscessom. Raspredelenie operativnyh vmeshatel'stv bylo sleduyushchim: 28,2% — abdominal'nyh, 23,2% — torakal'nyh, 15,6% — pri gnojnyh zabolevaniyah myagkih tkanej, 32,8% — prochih. V posleoperacionnom periode letal'nost' sostavila 22,2%. Po rezul'tatam issledovaniya mozhno sdelat' vyvod, chto novaya koronavirusnaya infekciya COVID-19 u pacientov s tuberkulezom, podvergnutyh ekstrennym operativnym vmeshatel'svam, ne vnesla sushchestvennogo vklada v uvelichenie posleoperacionnoj letal'nosti.

The double burden of the novel coronavirus infection and tuberculosis (TB) is a global challenge. The aspects of emergency surgical care for patients with COVID-19 and TB coinfection remain understudied. The aim of this study was to assess treatment outcomes in acute surgical patients with COVID-19 and preexisting TB coinfection. In 2020, our Center delivered surgical care to 465 patients with COVID-19 and preexisting TB; a total of 64 emergency surgeries were performed on 36 (5.6%) patients, of whom 16 had HIV. Thirteen patients (36.1%) were diagnosed with pulmonary TB; 23 patients (63.9%) had disseminated TB. Chest CT scans showed >25% lung involvement in 61.9% of the patients with COVID-19 pneumonia, 25–50% lung involvement in 30.6% of the patients, and 50–75% lung involvement in 5.6% of the patients. By performing abdominal CT, we were able to detect abdominal TB complications, including perforated tuberculous ulcers of the intestine, intestinal obstruction and tuberculous peritonitis, as well as tuberculous spondylitis complicated by psoas abscess. Of all surgical interventions, 28.2% were abdominal, 23.2% were thoracic, 15.6% were surgeries for soft tissue infection, and 32.8% were other types of surgery. Postoperative mortality was 22.2%. We conclude that COVID-19 did not contribute significantly to postoperative mortality among acute surgical patients with TB.

The differential diagnosis of intestinal tuberculosis and Crohn’s disease is a difficult task for most specialists due to their high similarity in clinical manifestations, instrumental diagnosis and histological pattern.The aim: to consider the clinical and diagnostic features of intestinal tuberculosis and Crohn’s disease, to show the role of various methods of their diagnosis (CT of the abdominal cavity, CT-enterography, colonoscopy with biopsy).A clinical example shows a case illustrating the difficulties of diagnosing intestinal tuberculosis, initially diagnosed as Crohn’s disease. The features of the course, complex diagnosis and treatment of intestinal tuberculosis and its complications during immunosuppression are demonstrated. At the first stage of treatment, the patient’s data related to CT of the chest organs, colonoscopy and histological examination of biopsy samples were incorrectly interpreted. As a result, a wrong diagnosis of Crohn’s disease was made, and immunosuppressive therapy was prescribed that provoked a generalization of the existing tuberculosis process. Subsequently, repeated surgical interventions were performed for complications of intestinal tuberculosis – perforation of tuberculous ulcers, peritonitis. Based on the analysis of the literature data and our own observation, it is shown that granulomatous inflammation in the study of intestinal biopsies doesn’t always allow us to make a clear diagnosis, first of all, there are intestinal tuberculosis and Crohn’s disease in the differential diagnostic series. The use of histobacterioscopy according to Ziehl – Neelsen, the study of fecal matter by luminescent microscopy, as well as molecular genetic methods for detecting DNA MTB allow us to verify the diagnosis. If Crohn’s disease is misdiagnosed as intestinal tuberculosis, then the prescribed anti-tuberculosis therapy can cause harm and lead to a delay in the underlying disease treatment. The reverse misdiagnosis is potentially more dangerous: if tuberculosis is misdiagnosed as Crohn’s disease, then the appointment of immunosuppressive therapy can lead to the generalization of tuberculosis and the development of fatal complications.

Currently tuberculosis is considered as a group of diseases united by one etiological factor. The pathogenesis of certain localizations of tuberculous inflammation, in particular peritoneum tuberculosis, hasn’t been sufficiently studied. The role of cytokine mechanisms in the development of the disease and the elaboration of non-sterile immunity requires further experimental studies, in particular the creation of a reproducible model on laboratory animals.The aim: to study the effect of TNF-α on the development of tuberculosis of the serous coat of the abdominal cavity, as well as to evaluate the possibility of modeling tuberculous peritonitis in laboratory animals using infliximab.Materials and methods. The studies were conducted on 18 male rabbits, which were simulated peritoneal tuberculosis by intra-abdominal administration of a suspension of Mycobacterium tuberculosis. 10 rabbits of the experimental group were intravenously injected with an infliximab solution and an iron (III) hydroxide sucrose complex intraperitoneally a day before infection.Results. In the control group of animals, tuberculosis either didn’t develop, or in a third of cases it affected only the pulmonary parenchyma, while proliferative processes prevailed. On the contrary, in animals with inactivated TNF-α, in 100 % of observations, tuberculous peritonitis was detected with associated lung damage and the predominance of alterative caseous processes.Conclusion. The created model of tuberculous peritonitis shows the leading role of TNF-α in the activation of macrophages, as well as in attracting cells to the site of infection. This is the primary signal necessary for the formation and stability of granulomas since the neutralization of this cytokine leads to a loss of control over the infection and the destruction of the granuloma with the development of destructive tuberculosis in the serous coat of the abdominal cavity.

Animal modeling of tuberculosis is necessary to study the pathogenesis of the disease and the immune response. Attempts to simulate various models of pulmonary and extrapulmonary tuberculosis made on laboratory animals that are considered the most susceptible to tuberculosis infection. The simulation of extrapulmonary forms of tuberculosis has serious difficulties and the number of patented models is extremely limited. Due to the frequent cases of tuberculosis extrapulmonary manifestations among the cohort of patients with immunosuppressive state, it is necessary to study the pathogenesis and combined organ-lesions in abdominal tuberculosis, to develop possible options for conservative and surgical treatment. To do this, it is necessary to return to the modeling of a specific process and to the search for the optimal model animal. Materials and methods. We considered mice and rabbits as the optimal model. The first experimental infection was carried out on 5 male mice of the C57/Black6 line and 10 male rabbits of the Soviet Chinchilla breed, which were infected by intraperitoneal injection of a suspension of Mycobacterium tuberculosis. Results. No signs of tuberculous inflammation of the peritoneum and intestines found in any of the animal species. Generalized tuberculosis detected in all mice without the formation of a granulomatous process. In a case of the rabbits, four animals showed the complete absence of signs of tuberculosis, and the other six had a lesion of the lung tissue only, at that morphologically pulmonary tuberculosis was similar to human tuberculosis in many respects. Conclusion. The results of our experiment indicate the practicability of using rabbits for modeling abdominal tuberculosis, similar in its chronic course and morphological features to human tuberculosis.

Nablyudaemyj v poslednie desyatiletiya rost chisla sluchaev tuberkuleznogo peritonita obuslovlen limfogematogennym rasprostraneniem mikobakterij tuberkuleza (MBT) iz legkih i drugih ekstrapul'monal'nyh istochnikov. Do sih por ostaetsya neyasnym, pochemu pri generalizacii tuberkuleznoj infekcii v vospalitel'nyj process vovlekayutsya te ili inye organy i anatomicheskie oblasti. Pochemu v odnih sluchayah razvivaetsya tuberkulez bryushiny, a v drugih tuberkulez pochek? Cel'yu raboty bylo izuchit' patogenez tuberkuleznogo peritonita s pomoshch'yu sozdaniya vosproizvodimoj biologicheskoj modeli. Tuberkuleznyj peritonit modelirovali na 18 krolikah (10 osobej — eksperimental'naya gruppa, 8 — kontrol'naya) putem vnutribryushinnoj inokulyacii vzvesi MBT. Krolikam eksperimental'noj gruppy pered zarazheniem vvodili ingibitor TNF — i zheleza (III) gidroksid saharoznyj kompleks s cel'yu podavleniya aktivnosti peritoneal'nyh makrofagov i osnovnyh citokinov; v kontrol'noj gruppe vvedenie immunosupressivnyh preparatov ne proizvodili. Pri autopsii zhivotnyh kontrol'noj gruppy v 37,5% sluchaev vyyavleny izmeneniya, harakternye dlya tuberkuleza legkih, porazheniya drugih organov i sistem ne otmecheno. Naprotiv, u krolikov eksperimental'noj gruppy v bryushnoj polosti vyyavleny priznaki tuberkuleznogo peritonita. Po rezul'tatam provedennoj raboty, anatomicheskaya oblast', gde razvivaetsya vtorichnyj ochag vnelegochnoj tuberkuleznoj infekcii, vo mnogom zavisit ot mestnoj immunnoj zashchity. Tak, dlya bryushiny takim neobhodimym i dostatochnym usloviem razvitiya tuberkuleznogo peritonita yavlyayutsya umen'shenie pula peritoneal'nyh makrofagov i snizhenie citokinovoj produkcii.

The literature review provides data on tuberculosis of the urethra in men. This disease is rarely recorded, as a rule, at the stage of formation of the urethral stricture, which can develop many years after the onset of the disease. Urethral tuberculosis is usually secondary to other localizations of extrapulmonary tuberculosis, such as tuberculosis of the prostate, penis, kidney, and bladder, but there are also isolated forms of this disease. The most common symptoms of urethral tuberculosis are the presence of strictures, skin-urethral and recto-prostatic fistulas, and purulent urethritis. Almost always, with this disease, conservative specific therapy was carried out, which in some cases made it possible to completely eliminate the symptoms and ensure the patient’s clinical recovery. Tuberculous urethral strictures are operated on according to generally accepted rules, but there is no single algorithm for the surgical treatment of strictures of this etiology, often limiting itself only to urine diversion or urethral dilation. Of the urethroplasty, the most commonly used end-to-end urethral anastomosis. In our opinion, a promising direction is the use of various grafts for the surgical treatment of this disease.

Primary (hematogenic) peritonitis caused by non-tuberculosis mycobacteria is extremely rare in the clinical practice. The main number of reported episodes of primary intraabdominal infection is associated with M. tuberculosis and the development of granulomatous inflammation of the peritoneum visually similar to carcinomatosis. The vast majority of reports of peritonitis associated with non-tuberculosis mycobacteria are interlinked with chronic peritoneal dialysis or foreign bodies of the abdominal cavity, when an infection is carried out by the contact through a dialysis catheter, prosthesis or a gastric banding device. The article describes a clinical case of peritonitis and splenitis caused by M. avium with hematogenic spread of infection from the primary pulmonary focus in a young patient with immunosuppression. Diagnosis of such peritonitis at the preoperative stage is extremely difficult due to the similarity of symptoms with atypical appendicitis or infected ascites. The intraoperative picture also did not allow us to assume a mycobacterial etiology of the process, and the absence of a focal point of peritonitis made it necessary to thoroughly understand the situation. Only a peritoneal biopsy and a complete laboratory examination of exudate allowed us to verify the diagnosis, to understand the pathogenetic mechanisms of the disease and to start a timely etiotropic therapy.

OBJECTIVE:To study and systematize clinical symptoms of tuberculous perivisceritis, to clarify diagnostic value of laboratory and instrumental survey in these patients and to identify the features of surgical treatment.MATERIAL AND METHODS:There were 8 patients with tuberculous perivisceritis. Examination included computed tomography of the abdominal cavity and chest, ultrasound, laparoscopy. All patients underwent surgical treatment with histological, cytological, microbiological and molecular genetic analysis of peritoneal exudate and biopsy of peritoneal specimens.RESULTS:Clinical picture of tuberculous perivisceritis is variable and non-specific. Periods of exacerbation are replaced by periods of prolonged remission. The complex of radiological survey used in verification of perivisceritis does not allow accurate determining the nature of disease. However, peritoneal tuberculosis may be suspected as a rule considering signs of thickening of the peritoneum. Objective confirmation of perivisceritis is possible only during surgical intervention. In this case, etiological factor can be established only after a thorough histological examination of resected fibrous capsule.CONCLUSION:Clinical picture of tuberculous perivisceritis does not have specific symptoms. The disease is characterized by prolonged and undulating course. Acute peritonitis and acute intestinal obstruction may be suspected during exacerbation of the pathological process. Laparotomy followed by complete excision of fibrous capsule and adhesiolysis is preferred.