Journal of Nepal Medical Association (Jan 2004)
Abdominal Tuberculosis
Abstract
Tuberculosis is a common disease and its incidence is in rising tendency in developed world because of AIDS and transglobal migration. Abdominal tuberculosis is more common in immunocompromised population and manifests as infection of peritoneum, hollow or solid abdominal organs and abdominal lymphatics with mycobacterium tuberculosis organism. The peritoneum and ileo-cecal region are the most likely sites of infection and are involved in the majority of cases by hematogenous spread or through swallowing of infected sputum from primary pulmonary tuberculosis. Pulmonary tuberculosis is evident in less than half of patients either in active or latent form. Abdominal tuberculosis has a protean manifestation although the most common clinical feature is the triad of abdominal pain, fever and weight loss. The diagnosis is often delayed because of non-specific presentation and is usually made through a combination of radiologic, microbiologic, histopathologic, endoscopic and molecular techniques. None of them provide a gold standard by themselves. However, an algorithm of these diagnostic methods leads to considerably higher precision in the diagnosis of abdominal tuberculosis which primarily necessitates a clinical awareness of this serious health problem. Abdominal tuberculosis is a serious condition and if untreated outcome is fatal. Early diagnosis and immediate initiation of treatment along with dietary support is crucial for better outcome. Antimicrobial treatment is the same as for pulmonary tuberculosis and management often requires combination of antitubercular drugs and surgery – for diagnosis as well as therapy. Key Words: Tuberculosis; Abdominal Tuberculosis; Extrapulmonary Tuberculosis.