Surgical aspects of intestinal tuberculosis in children: Our experience

Mirza, Bilal; Ijaz, Lubna; Saleem, Muhammad; Sheikh, Afzal

doi:10.4103/0189-6725.86059

Cited by 7 publications

(16 citation statements)

References 4 publications

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“…In a study of 80 adults with ATB by Keshri et al [21], 13 (16.3%) had been on ATT prior to developing complications requiring surgical intervention. Mirza et al reported that 4 of 18 children (22%) on ATT required surgery [22]; most of our patients were diagnosed to have tuberculosis and were on ATT prior to the acute presentation. This calls attention to the need to be constantly vigilant during and even after completion of treatment for ATB, and to be prepared for early intervention in affected children and adults.…”

Section: Discussionmentioning

confidence: 55%

Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience

Arbab

Khan²,

Amanullah³

et al. 2021

J Pediatr Adolesc Surg

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Background: Although uncommon in children, abdominal tuberculosis (ATB) can be a life-threatening condition with a subset requiring emergency surgical intervention. This study aims to determine the presentation, surgical procedures performed, and outcomes in children affected by abdominal tuberculosis. Methods: A retrospective chart review of all children undergoing surgical intervention for ATB from July 2007 to December 2018 was conducted. Data were analyzed using SPSS version 22. Results: Of 340 children with a diagnosis of ATB seen at the Indus Hospital’s TB clinic, 14 (4%) underwent laparotomy. Females were affected more commonly (57%), with a mean age at presentation of 11 years (range 8-14). Nine children required laparotomy for documented perforation, while 5 had an intestinal obstruction. Most children (n=10) had an established diagnosis of ATB before the surgical intervention; 2 children had completed 6–9 months anti-tuberculous treatment (ATT) courses, while 8 children had been on ATT for a mean period of 2.5 months at the time of developing acute surgical symptoms. Diversion ileostomy was made in 64%. Postoperative complications included sepsis (n=4), wound infection (n=3), abdominal collection (n=2), enterocutaneous fistula (n=2), and abdominal wound dehiscence requiring formal closure (n=2). There were 4 mortalities (29%); 10 patients were discharged after a median in-hospital stay of 12 days (range 6-35) of which 6 with ileostomies underwent reversal after completion of the ATT course. Conclusion: ATB has high morbidity and mortality. Perforation and obstruction can occur during or after the completion of ATT. Management requires early recognition and surgical intervention as indicated.

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Section: Discussionmentioning

confidence: 55%

Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience

Arbab

Khan²,

Amanullah³

et al. 2021

J Pediatr Adolesc Surg

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“…In the case of a subacute presentation, there may be subacute intestinal obstruction, alternation of constipation and diarrhea, palpable abdominal mass, chronic abdominal pain and weight loss [18]. The reported patient had a clinical picture compatible with subacute presentation with abdominal pain and chronic diarrhea, which due to the diagnostic delay was complicated by multiple intestinal perforations at the ileocecal level that required surgical intervention.…”

Section: Discussionmentioning

confidence: 94%

Complicated Gastrointestinal Tuberculosis in Children: Case Report

Rodrigo¹

2017

GHOA

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| http://medcraveonline.com lymphadenopathy, peritoneal tuberculosis, gastrointestinal tuberculosis and visceral tuberculosis of solid organs [2,7]. The clinical manifestations of the abdominal tuberculosis are nonspecific and can imitate many other diseases such as Crohn's disease, causing a delay in the diagnosis and therefore may present with complications [8-10]. We present the case of a 6 year old girl with multisystemic tuberculosis and intestinal involvement complicated by intestinal perforation. Case Report 6 year-old female patient entered the emergency department with abdominal pain, reporting one months history of diarrhoea with mucus and blood approximately 10 times per day, night fever, hiporexia and loss of weight not quantified. On examination: HR 110, RR:30 T: 38.3°C, Sat O 2 : 98%, awake, breathing spontaneously, pale and with decreased subcutaneous adipose tissue. Palpable cervical lymph nodes. Abdomen: Distended, tender and with resistance to palpation. Liver palpated 4 cm below right costal margin. No splenomegaly. The patient was admitted to the emergency department with the following diagnoses: Abdominal Sepsis, Chronic Diarrhea, Severe Malnutrition. She was later admitted to the department of Infectious Diseases for further investigations. During her hospitalization, she deteriorated and developed an acute surgical abdomen on day 3. An Abdominal X-ray showed a pneumoperitoneum (Figure 1), which was evaluated by the surgical service. The surgeons suggested an exploratory laparotomy. In theatre, they found multiple perforations secondary to obstructions in the ileum with mesenteric lymphadenitis. The enlarged lymph nodes appeared to contain caseous necrosis. Peritoneal cavity lavage, intestinal resection and Ileostomy were performed. A sample of intestinal tissue was sent for smear microscopy and culture which identified Mycobacterium tuberculosis complex (MTC). The immunocromatography, also detected the MTC and was sensitive to all the first-line anti-Volume 8 Issue 3-2017

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“…Over the last 20 years, the UK has seen a general decline in the incidence of pulmonary TB, but a rise in extrapulmonary TB, especially among non-UK born patients [2,10,13,14]. Worldwide, the risk of abdominal TB in children increases with deterioration in socioeconomic status and increased frequency of HIV infection [8,10,13,15]. As a result, HIV testing is recommended to all patients presenting with TB [1].…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal tuberculosis (ATB) accounts for 5% cases of extrapulmonary TB and refers to infection of the gastrointestinal tract (GIT), the mesentery, and its nodes, omentum, peritoneum, and related solid organs [3,5,6]. It usually presents in a clinical spectrum that ranges from non-specific symptoms to those that mimic Crohn's disease or abdominal carcinomatosis [5,[7][8][9]. Peritoneal TB (PTB) is a very rare form of TB and accounts for only 1-2% of cases of TB, 31-58% of cases of abdominal TB [9].…”

Section: Introductionmentioning

confidence: 99%

Abdominal tuberculosis masquerading as carcinomatosis: Not difficult to miss!

Christiana¹,

Arora²,

Abayasekara³

2021

Int J Case Rep Images

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Introduction: Abdominal tuberculosis (ATB) is a rare extrapulmonary manifestation of Mycobacterium tuberculosis infection. It usually presents with nonspecific symptoms that can mimic other intra-abdominal conditions like acute appendicitis, Crohn's disease, ovarian pathology, and intra-peritoneal carcinomatosis and is therefore, easy to overlook. Diagnosing ATB in the pediatrics population tends to be even more challenging as an obvious history of exposure may be difficult to obtain. Chronicity of symptoms and lack of Bacillus Calmette-Guérin (BCG) scar should raise suspicion. Diagnostic laparoscopic biopsy and histopathology provides definitive diagnosis.Case Report: This case report presents the case of a 16-year-old girl with a history of recurrent abdominal pain, vomiting, and pyrexia. At initial diagnostic laparoscopy, she underwent laparoscopic appendectomy. Vesicles were noted in the pelvis. The patient failed to improve. Exposure to tuberculosis (TB) was denied. Review of preoperative computed tomography (CT), comprehensive re-laparoscopy, and histopathology of appendix were used for final diagnosis of this condition. The patient was treated using anti-TB therapy for six months following which, she was able to make a full recovery. Conclusion:Abdominal TB is very difficult to diagnose in young patients and should be considered in those

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Surgical aspects of intestinal tuberculosis in children: Our experience

Abstract: Acute peritonitis, intestinal obstruction and intestinal perforation are the main clinical presentations requiring surgical interventions. Optimal surgical strategy should be adopted to avoid such pitfalls in the management.

Cited by 7 publications

References 4 publications

Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience

Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience

Complicated Gastrointestinal Tuberculosis in Children: Case Report

Abdominal tuberculosis masquerading as carcinomatosis: Not difficult to miss!

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