Small bowel obstruction secondary to abdominal tuberculosis
DOI:
https://doi.org/10.18203/2349-2902.isj20252306Keywords:
Intestinal TB, Tuberculosis, Solid viscera, Anti-TB medications, Crohn’s disease, Immunosuppressed, Extrapulmonary TB, Mesenteric lymph nodesAbstract
Tuberculosis (TB) remains a serious public health concern in developing countries to date. Gastrointestinal involvement secondary to pulmonary TB is seen in 55-90% of the adult population. Intestinal TB is prevalent in immunosuppressed patients in underdeveloped countries and constitutes 12% of extrapulmonary TB cases. However, it poses a diagnostic challenge due to its non-specific features and underlying complications. Intestinal TB often involves the GI tract, peritoneum, mesenteric lymph nodes, and solid viscera of the abdomen. Here we present a known case of TB in a 39-year-old female, non-compliant with anti-TB medications. She presented with complaints of diffuse abdominal pain, generalized weakness and constipation. She was suspected of having small bowel obstruction. On evaluation, the Mantoux test was positive and the spread of extrapulmonary TB in the form of multiple calcified granulomas was seen in solid visceral organs such as the liver and spleen, along with omentum and mesenteric lymph nodes, which we believed was a rare clinical presentation in Intestinal TB cases. The patient was surgically managed and discharged in stable condition.
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References
Wallis RS, Maeurer M, Mwaba P, Chakaya J, Rustomjee R, Migliori GB, et al. Tuberculosis-advances in development of new drugs, treatment regimens, host-directed therapies, and biomarkers. Lancet Infect Dis. 2016;16(4):e34-46. DOI: https://doi.org/10.1016/S1473-3099(16)00070-0
Goldani LZ, Spessatto CO, Nunes DL, Oliveira JG, Takamatu E, Cerski CT, et al. Management of severe gastrointestinal tuberculosis with injectable antituberculous drugs. Trop Med Heal. 2015;43(3):191-4. DOI: https://doi.org/10.2149/tmh.2015-09
Shaikh MS, Dholia KRAM, Jalbani MA, Shaikh SALI. Prevalence of intestinal tuberculosis in cases of acute abdomen. Pak J Surg. 2007;23(1):52-6.
Park H, Kansara T, Victoria AM, Boma N, Hong J. Intestinal tuberculosis: a diagnostic challenge. Cureus. 2021;13(Iv):2-5. DOI: https://doi.org/10.7759/cureus.13058
Castellotti P, Riccardi N, Ferrarese M. Intestinal tuberculosis versus inflammatory bowel diseases: a never-ending challenge. New Microbiol. 2020;43(3):139-43.
Weledji EP, Pokam BT. Abdominal tuberculosis: is there a role for surgery? World J Gastrointest Surg. 2017;9(8):174. DOI: https://doi.org/10.4240/wjgs.v9.i8.174
Tan KK, Chen K, Sim R. The spectrum of abdominal tuberculosis in a developed country: a single institution’s experience over 7 years. J Gastrointest Surg. 2009;13(1):142-7. DOI: https://doi.org/10.1007/s11605-008-0669-6
Dhali ADK, Das K, Dhali G, Ghosh R, Sarkar A, Misra D. Abdominal tuberculosis: clinical profile and outcome. Int J Mycobacteriol. 2021;10:414-20. DOI: https://doi.org/10.4103/ijmy.ijmy_195_21
Ladumor H, Al-Mohannadi S, Ameerudeen FS, Ladumor S, Fadl S. TB or not TB: a comprehensive review of imaging manifestations of abdominal tuberculosis and its mimics. Clin Imaging. 2021;76:130-43. DOI: https://doi.org/10.1016/j.clinimag.2021.02.012
Kentley J, Ooi JL, Potter J. Intestinal tuberculosis: a diagnostic challenge. Trop Med Int Health. 2017;22(8):994-9. DOI: https://doi.org/10.1111/tmi.12908
Pattanayak S, Behuria S. Is abdominal tuberculosis a surgical problem? Ann Royal College Surgeons Eng. 2015;97(6):414-9. DOI: https://doi.org/10.1308/rcsann.2015.0010
Eraksoy H. Gastrointestinal and abdominal tuberculosis. Gastroenterol Clin North Am. 2021;50(2):341-60. DOI: https://doi.org/10.1016/j.gtc.2021.02.004