Abdominal tuberculosis. A review

Abstract

As long as tuberculosis remains uncontrolled, abdominal tuberculosis, like other forms of tuberculosis, will be commonly met with. About 70 to 100% of all granulomatous lesions, according to different workers, are of tuberculous etiology in India. 15% of all fistulas-in-ano are of tuberculous origin. 3.4 to 11% of all intestinal obstructions and 5.7% of all intestinal perforations are due to tuberculosis. Primary abdominal tuberculosis is very rare. Secondary lesions can be of hematogenous origin or direct spread from a pulmonary tuberculosis lesion by means of swallowed sputum. Primary lesions, if seen at all, will be in infants and small children for they can pick up objects soiled with sputum of a tuberculous patient and put them in their mouth. Abdominal tuberculosis (secondary intestinal) is common in the 3rd and 4th decades of life and females predominate. Tuberculous peritonitis is common in school-going children, adolescents and young persons especially females. Hypertrophic ilieocecal tuberculosis is common in young adult males. In the intestinal lesions, there are two common types - ilieocecal hypertrophic lesions, and ulcero-constrictive lesions in the ileum. Although any part of the alimentary canal can be affected, lesions of the esophagus, stomach and rectum are very rare. Symptoms and signs are very variable and clinical diagnosis almost impossible. The only convincing way to prove the diagnosis is to do bacteriological and histopathological examination of the biopsy specimens obtained by peritonoscopy or laparotomy. Anti-tuberculosis drugs, along with surgical intervention which is required quite often, give satisfactory results.