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At surgery, the tissues from the subcutaneous tissues to the peritoneum were seen to be quite edematous. Distinguishing between these two entities is a challenge because there is marked overlap in the clinical presentation and the radiographic, laboratory, and endoscopic findings, as well as in the presence of granulomas on histological examination[31-33]. Among 33 patients who underwent bowel resection, 14 had ileo-cecal resection/right hemicolectomy. Laparoscopy is most reliable as it is minimally-invasive effective modality for diagnosis of peritoneal TB, and can be performed under local anaesthesia. Patients have been diagnosed with lymphoma, mesothelioma, appendiceal mass, or inflammatory bowel disease.
Peritoneal TB must be differentiated from carcinomatosis, talc peritonitis, bacterial peritonitis, and from ascites due to heart failure or liver disease (Table 1). Registered users can save articles, searches, and manage email alerts. Abdominal tuberculosis was considered and the operation ended after a peritoneal biopsy, and ascites fluid samples were taken.
Nine of 28 patients presented acutely and a wide variety of preoperative diagnoses were entertained. Haddad FS, Ghossain A, Sawaya E, Nelson AR. In a high prevalent area in sub-Saharan Africa, the common presenting symptoms and signs were abdominal pain 76.6%; ascites 59.6%; weight loss 53.2% and fever 29.8%. There are a variety of ways of obtaining tissue for histology. 0000009164 00000 n A few patients with only nodal disease present with an abdominal mass consisting of enlarged mesenteric lymph nodes[2,6]. Direct stains and culture of stool specimens may sometimes be positive, but the yield is generally low[23]. Genitourinary TB may present in a similar manner to pelvic inflammatory disease (PID), with chronic low-grade pelvic pain and ultimately with amenorrhoea and infertility. Keywords: The posteroanterior chest and plain abdominal radiographs showed nonspecific findings (Fig. Andronikou S, Welman CJ, Kader E. The CT features of abdominal tuberculosis in children. Obstruction is the most common complication with multiple and/or long strictures less likely to respond to medical therapy[40,43]. Tuberculous peritonitis is usually due to reactivation of a tuberculous focus in the peritoneum with concurrent pulmonary, intestinal or genital TB (especially from the fallopian tubes). A retrospective analysis was done of the surgical procedures performed in patients with abdominal tuberculosis in a large tertiary-care center in North India. trailer Annals of Tropical Medicine & Parasitology. Abdominal tuberculosis (TB) continues to represent a diagnostic challenge to clinicians[1]. Tuberculous peritonitis in an adolescent male. Intestinal perforation and acute bleeds do occur, but are unusual.
In the United States, among native-born white Americans, abdominal TB is primarily a disseminated disease of elderly, debilitated patients with chronic illnesses. However, demonstrating the alcohol–acid-resistant bacilli is possible only in 20–70% of the cases 5,6.
Rao YG, Pande GK, Sahni P, Chattopadhyay TK. 0000235380 00000 n About 90% of the features of abdominal TB in children are due to involvement of the peritoneum and lymph nodes and 10% related to intestinal lesions[4-6]. Adhesiolysis of gut (47.3%), strictureplasty (10.5%), resection anastomosis (5.2%), right hemicolectomy (5.2%), and ileotransverse anastomosis (7.8%) were performed and peritoneal biopsy and lymph node biopsy in 21% of patients. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, By continuing to browse this site, you agree to its use of cookies as described in our, I have read and accept the Wiley Online Library Terms and Conditions of Use. The average duration of symptoms before presentation was 3 mo and 13% of patients had earlier been treated for pulmonary TB[10]. For patients in whom the diagnosis is strongly suspected, but for whom the histological proof is unobtainable or inconclusive, it is justifiable to undertake a trial of anti-tuberculous therapy[10,41]. Your message has been successfully sent to your colleague. Primary anastomosis and stoma creation was performed in 12 (36%) and 21 (64%), respectively. Diagnostic laparoscopy is increasingly useful but joint decision making with physician familiar with anti-tuberculous therapy is important. A total of 139 patients diagnosed as having abdominal TB who received anti-TB medication from January 2005 to June 2016 were reviewed. Acute Problems and Emergency Surgery: Surgery in the Tropics. Surgeons must be aware of the wide clinical spectrum of abdominal TB and have a high index of suspicion when confronted with patients from an endemic area presenting with unclear abdominal symptoms[2,6].
0000011637 00000 n In practice, the various forms may coexist[6,7]. Granulomata develop in the tubes and subsequently the other genital organs. Twenty-eight patients had intestinal strictures, with the ileum being the most common site (n = 21). 0000005092 00000 n As abdominal TB should be considered in all cases with ascites. 0000366336 00000 n NIH The ileocaecal region is the most common site of involvement (75%) because of increased physiological stasis, fluid and electrolyte absorption, minimal digestive activity and abundance of lymphoid tissue (Peyer’s patches)[12]. Radiologically, nonspecific free fluid and increased mesenteric echo in the acute stage with peritoneal involvement were seen. endstream endobj 52 0 obj<.
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