Abdominal tuberculosis

Abstract

Summary Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality.

Abdominal tuberculous lymphadenopathy: MRI features

“…Usually, however, cell-mediated immunity controls these infections and causes bacterial destruction; however, sometimes viable inactive bacteria may remain as a source for tuberculosis reactivation, making multiple organ involvement possible at a later date. Reactivation may occur with suppression of host defences [6,7].…”

“…The abdomen is involved in 11-16% of patients with extrapulmonary tuberculosis [6]. Tuberculous lymphadenopathy is the most common manifestation of abdominal tuberculosis.…”

Gastrointestinal tuberculosis: a diagnosis not to miss

“…We have also seen cases which have proven difficult to distinguish from inflammatory bowel disease, as others have also reported. [1][2][3] These cases support the need to confirm, whenever possible, all clinical diagnoses by either histology or, where relevant, microbiology, to avoid making serious errors. That this was not done in many of these cases probably reflects the fact that TB may no longer be included in the differential diagnosis of patients presenting with gastrointestinal problems, even in an area of the UK such as Slough, with a high ethnic minority population and where the local incidence of TB is relatively high.…”

“…Tuberculosis can affect the entire gastrointestinal tract, including the liver, spleen and pancreas. 1 Tuberculosis infection within the abdomen confers a significant degree of morbidity and mortality of all cases, comprising up to 12% of extra pulmonary TB and 1-3% of the total. 1 It can often mimic many gastrointestinal diseases, especially inflammatory bowel disease, which may result in delayed and inappropriate treatment.…”

Keine gewöhnliche perianale Fistel...

“…Die Therapie der Darmtuberkulose unterscheidet sich nicht vom Vorgehen bei pulmonaler Tuberkulose, wobei Perforationen, Abszesse und Fisteln gegebenenfalls operativ saniert werden müssen [4]. Eine häufige Nebenwirkung der antituberkulösen Therapie ist eine medikamenteninduzierte Hepatopathie, die sich in einem meist reversiblen Anstieg der Leberenzyme äußert und durch Modifikation der tuberkulostatischen Medikation umgangen werden kann.…”