Abdominal tuberculosis in patients with acute abdomen: an observational single centre study

Authors

  • Bhanu Sharma Department of Surgery, St. Stephens Hospital, New Delhi, India
  • Rajeev Sharma Department of Surgery, St Stephens Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20231964

Keywords:

Abdominal tuberculosis, Ultrasound, CECT whole abdomen, Colonoscopy, Gene Xpert

Abstract

Background: Abdominal tuberculosis tends to present with nonspecific features and can be hard to diagnose. Abdominal tuberculosis can mimic a variety of other abdominal conditions and only a high degree of suspicion can help in the diagnosis, otherwise, it is likely to be missed or delayed resulting in high morbidity and mortality. Therefore, a high index of suspicion, fortified with a general degree of awareness and knowledge of this form of the disease is essential.

Methods: A careful history taking, and thorough clinical examination was carried out in each case. All the patients were investigated. Some of the patients needed surgical intervention. For patients who responded favorably to conservative management and did not require surgery, diagnostic studies were carried out to confirm the presence of abdominal tuberculosis.  

Results: Abdominal tuberculosis constituted a significant percentage (23.6%) of all cases attending the emergency with an acute abdomen. Ultrasound and CECT can show various findings which can be suggestive of abdominal tuberculosis, but there is no significant difference in PPV of ultrasound and CECT abdomen. Colonoscopy has PPV of 55.6% in diagnosis of abdominal tuberculosis. Gene Xpert is significantly better than AFB staining in diagnosing the abdominal tuberculosis with ascitic fluid examination.  

Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and prompt management of this curable disease. Ultrasound and CECT can be suggestive of abdominal tuberculosis, but final diagnosis can be made only after histopathological examination/with gene Xpert report. 

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References

Paustian FF. Tuberculosis of the intestines. Bockus Gastroenterol. 1976;12:750-7.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316-53.

Sharma SK, Mohan A, Kadhiravan T. HIV-TB Co-Infection: Epidemiology, Diagnosis and Management. Indian J Med Res. 2005;121(4):550-67.

Shimy GG, Borham MM, MB GM. Incidence of tuberculosis in acute abdomen in endemic area. Al-Azhar Assiut Med J. 2013;11.

Mukhopadhyay A, Dey R, Bhattacharya U. Abdominal tuberculosis with an acute abdomen: our clinical experience. J Clin Diagnostic Res. 2014;8(7):NC07.

Shaikh MS, Dholia KR, Jalbani MA, Shaikh SA. Prevalence of intestinal tuberculosis in cases of acute abdomen. Pakistan J Surg. 2007;23:52-6.

Singh A, Sahu MK, Panigrahi M, Behera MK, UthanSingh K et al. Abdominal tuberculosis in Indians: Still very pertinent. J Clin Tuberculosis Mycobacterial Dis. 2019;15:100097.

Urabinahatti KA, Singh AK, Nayak A, Gupta R, Jain M et al. Abdominal tuberculosis: an epidemiological profile and management of 40 cases in a tertiary set up. Int Surg J. 2016;3(3):1502-8.

Cheng W, Zhang S, Li Y, Wang J, Li J. Intestinal tuberculosis: clinic-pathological profile and the importance of a high degree of suspicion. Trop Med Int Health. 2019;24(1):81-90.

Kedar RP, Shah PP, Shivde RS, Malde HM. Sonographic findings in gastrointestinal and peritoneal tuberculosis. Clin Radiol. 1994;49(1):24-9.

Flores LS, Solís AH, Gutiérrez AE, José LC, Ortiz IC, González HG et al. Peritoneal tuberculosis: A persistent diagnostic dilemma, use complete diagnostic methods. Rev Med Hosp Gen Méx. 2015;78(2).

Gupta VK, Mukherjee S, Dutta SK, Mukherjee P. Diagnostic evaluation of ascitic adenosine deaminase activity in tubercular peritonitis. J Asso Physicians India. 1992;40(6):387-9.

Vadwai V, Boehme C, Nabeta P, Shetty A, Alland D, Rodrigues C. Xpert MTB/RIF: a new pillar in diagnosis of extrapulmonary tuberculosis? J Clin Microbiol. 2011;49(7):2540-5.

Tortoli E, Russo C, Piersimoni C, Mazzola E, Dal Monte P et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur Respiratory J. 2012;40(2):442-7.

Kumar R, Digra M, Kumar D. Abdominal tuberculosis: a clinicopathologic study in Kashmir valley. Int Surg J. 2017;4(8):2470-4.

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Published

2023-06-28

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Original Research Articles