Abdominal tenderness is due to mild irritation or chronic inflammation of the peritoneum and is seen in all types of tuberculous peritonitis, but is generally considered to be a clinical feature of the adherent type of tuberculous peritonitis. The vast majority of patients have varying degrees of pressure pain, usually mild, with a few having significant pressure pain with rebound pain, the latter mostly seen in the caseous type. Tuberculous peritonitis is a chronic diffuse peritoneal inflammation caused by Mycobacterium tuberculosis infection of the peritoneum, which can be part of systemic hematogenous dissemination, but is more commonly seen as a direct spread of intestinal tuberculosis, mesenteric lymph node tuberculosis, or genitourinary tuberculosis. Tuberculous peritonitis accounts for approximately 5% of tuberculosis after pulmonary and intestinal tuberculosis. The incidence seems to be decreasing in recent years, but it is not uncommon to see patients with mild and atypical clinical manifestations, which are easily overlooked and misdiagnosed or missed, and should be taken seriously. Tuberculous peritonitis is caused by Mycobacterium tuberculosis, mostly secondary to other tuberculous lesions in the body. Symptomatic examination of abdominal “tenderness” signs: The disease is mostly slow in onset, but acute onset is not uncommon. The main symptoms are lethargy, fever, abdominal distension and abdominal pain, but there are also cases of sudden onset of chills and high fever. In mild cases, the disease starts to be insidious. Fever and night sweats are the most common, and the fever type is mostly low and moderate, with some patients showing tachyphylaxis. Patients with exudative and caseous cases or combined with severe extra-abdominal tuberculosis may present with fever and severe night sweats, and in severe cases there are signs of malnutrition such as anemia, emaciation, edema, orchitis and vitamin A deficiency. In women of childbearing age, menopause and sterility are more common. 2, abdominal pain Most patients can have different degrees of abdominal pain, mostly persistent vague or dull pain, pain mostly located around the umbilicus, lower abdomen, sometimes in the whole abdomen. When patients have acute abdomen, acute peritonitis caused by the ulceration of abdominal tuberculosis lesions should be considered, and tuberculous peritonitis rarely has perforation. 3, abdominal distension and ascites Most patients have abdominal distension, which can be caused by symptoms of tuberculosis toxicity or intestinal dysfunction associated with peritonitis. Patients may have ascites, with small and moderate amounts being common. Mobile turbid sounds may appear when the amount of ascites is high. 4, abdominal wall tenderness The tenderness is a clinical feature of adhesive tuberculous peritonitis. The vast majority of patients have varying degrees of tenderness, generally mild, and a few have significant tenderness and rebound pain, the latter mostly seen in the case type. 5, abdominal mass The abdomen of patients with adherent type and caseous type can often be palpated with a mass, mostly located in the middle and lower abdomen. The masses vary in size and have uneven edges, sometimes in the form of transverse masses or nodular sensation, and are mostly mildly painful to the touch. 6.Other Some patients may have diarrhea, and constipation is more common in patients with adhesion type, and sometimes diarrhea and constipation appear alternately. Hepatomegaly can be caused by fatty liver due to malnutrition or liver tuberculosis. If complicated by intestinal obstruction, peristaltic waves and hyperactive bowel sounds can be seen.