Abdominal tuberculosis in a district general hospital: a retrospective review of 86 cases

Abstract

The diagnosis can be difficult to make because of the varied presentation, the low percentage with positive microscopy for acid-fast bacilli and the time delay of up to several weeks for a positive TB culture. The thresholds for laparoscopy and/or laparotomy for the diagnosis were therefore very low. The diagnosis could be made rapidly by these methods, and early treatment instituted. Six months short-course chemotherapy is very effective in ATB. This should be changed, if appropriate, on the basis of drug susceptibility data.

A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis

“…The male female ratio is highly variable from equal in the series reported by Ramesh et al 80 to a male predominance reported in two studies 56,79 and to a marked female predominance in the study of Nafeh et al 78 In our series the male: female ratio of 1:3. The reasons for these variations are unclear.…”

“…78,80 U/S abdomen was suggestive of tuberculosis in all patients, but histology/culture results were positive in 55 patients. Though the sensitivity of CT scan was high, the specificity was very low in our series.…”

“…78,81 Fever was less common in our series (24%) than in others (46% to 92%). 78,79,80 Ascites was present in 94-95% of patients in some of the series in the past 18,78 and in 61-65% of patients in some of the recent series, 56,83 …”

“…Our series is biased due to suspected HIV being the entry criteria, however it is interesting to note that most of the reported series of abdominal tuberculosis in the literature are either HIV negative or not mentioned. 78,79,80 Reports from Zambia 81 , Nigeria 82 and India 15 indicate a lesser abdominal tuberculosis and HIV co-infection rate than South Africa. 11 Ghiya et al 15 The mean duration of symptoms of our patients was 41 days which is similar to other series.…”

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

“…Ileocecal tuberculosis was managed by right hemicolectomy with or without stoma, perforation along with multiple stricture resection anastomosis with a covering stoma or only stoma [22,23]. Typhoid enteric perforations were managed by either primary repair or only stoma, depending on the condition of the gut and general condition of the patient and also managed laparoscopically [24].…”