Clinical presentation Perforation peritonitis was the most frequent clinical presentation followed by intestinal obstruction. There was a wide age range, with the majority between the ages of 10 and 30. [jlponline.org]

Oedematous jejunal loop was present with no intussusception and multiple mesenteric and paraaortic lymph node were present, representive mesenteric lymph node was biopsied. [omicsonline.org]

The study subjects attended the outpatient department with acute or chronic presentations. [intechopen.com]

Abdominal tuberculosis can present with various clinical presentations and the diagnosis is based on the radiological and histopathological evidence. In our case the child presented with a mass per abdomen. [medresearch.in]

Perforation was present in 10 patients, of which six had multiple perforations. Cocoon abdomen was present in four patients, two of whom had associated small-bowel stricture. [liebertpub.com]

• Abdominal Lymphadenopathy

  For abdominal lymphadenopathy, these values were 36.84%, 66%, 47.83%, 55.26%, and 50.46%, respectively. [dovepress.com]

  Ultrasonography revealed abdominal lymphadenopathy, ascites, and mass lesions in 26, 12, and four patients, respectively. Barium examination showed abnormality in eight patients out of 18, among whom it was performed. [jgid.org]

  Ascites in 8 (36.3%), thickening of mesentery in 5 (22.7%), abdominal lymphadenopathy in 3 (13.6%), omental pathology in 3 (13.6%) and lymphadenopathy in liver hilum, cholelithiasis, destruction in sacral bone, ovary cyst and splenomegaly each for one [wjgnet.com]

  Abdominal lymphadenopathy in intestinal TB may be demonstrated with US and CT. The distribution of lymphadenopathy is sometimes difficult to differentiate from lymphoma. Contrast-enhanced CT may be useful in differentiating lymphomas from TB. [emedicine.medscape.com]

  For example, intra‐abdominal lymphadenopathy can be due to other infections (for example, cryptococcosis, histoplasmosis); lymphomas (non‐Hodgkin's lymphoma and Hodgkin's lymphoma); and Kaposi's sarcoma (Martin‐Bates 1993). [cochranelibrary.com]

• Pain

  Case 2 A 38-year-old male with a two-week history of moderate epigastric abdominal pain and 38ªC fever. Physical examination found pain in the epigastrium followed by rebound tenderness. [sages.org]

  Most patients presented with abdominal pain and ascites (22 cases), abdominal pain without ascites (four cases) and mixed forms of fibroadhesive type with multiple interloop cysts (two cases). [saudijgastro.com]

  Their usual presentation includes abdominal pain, weight loss, anemia, and fever with night sweats. Patients may present with symptoms of obstruction, hemorrhage, perforation right iliac fossa pain, or a palpable mass in the right iliac fossa. [omicsonline.org]

  Presenting features Abdominal pain was the predominant presenting feature. Fourteen patients reported a history of generalised abdominal pain. [nzma.org.nz]

  In intestinal tuberculosis abdominal pain, constipation and vomiting suggestive of intestinal obstruction are usually seen. Recurrent attacks of subcute intestinal obstruction occur. [oapublishinglondon.com]

• Lymphadenopathy

  Sonographic findings in all patients with abdominal tuberculosis included an echogenic thickened mesentery (> or = 15 mm) with mesenteric lymphadenopathy. [ajronline.org]

  The abdominal TB usually occurs in four forms: tuberculous lymphadenopathy, peritoneal tuberculosis, gastrointestinal (GI) tuberculosis and visceral tuberculosis. [medresearch.in]

  Peripheral lymphadenopathy (fixed or matted) is a helpful diagnostic clue. [onlinelibrary.wiley.com]

  Gastrointestinal tuberculosis Esophageal tuberculosis Gastric tuberculosis Duodenal tuberculosis Jejunal and ileocecal tuberculosis Colorectal tuberculosis Tubercular lymphadenopathy Abdominal lymphadenopathy is the most common manifestation of the abdominal [ncbi.nlm.nih.gov]

  Ascites in 8 (36.3%), thickening of mesentery in 5 (22.7%), abdominal lymphadenopathy in 3 (13.6%), omental pathology in 3 (13.6%) and lymphadenopathy in liver hilum, cholelithiasis, destruction in sacral bone, ovary cyst and splenomegaly each for one [wjgnet.com]

• Swelling

  Patients often present with localized abdominal swelling. In the fibrous form, widespread adhesions may cause the intestine (especially in the ileal region) to be matted together and distended. [patientcareonline.com]

  Omental swelling could be seen. Tubercles are sometimes studded on the gut, and involvement is diffuse giving mottling appearance to the gut. [oapublishinglondon.com]

  Common symptoms of abdominal tuberculosis are: Fever Loss of appetite Fatigue Weight loss Constipation Diarrhea Colicky pain in the abdomen Abdominal Swelling and tenderness Night sweats Diagnosis & Treatment of Abdominal Tuberculosis Diagnosis of abdominal [medindia.net]

  Then my stomach started swelling up. It swelled up to the size of a belly of a 7 months pregnant woman. After going from doctor to doctor, one doctor eventually diagnosed me with peritonitis. This meant that there was fluid in the peritonial area. [news24.com]

  Symptoms are usually insidious with abdominal pain, swelling, fever, night sweats, anorexia and weight loss. [4] Symptoms may even be absent in some patients. [saudijgastro.com]

• Surgical Procedure

  Methods: A retrospective analysis was done of the surgical procedures performed in patients with abdominal tuberculosis in a large tertiary-care center in North India. [liebertpub.com]

  The recommended surgical procedures today are conservative and a period of preoperative drug therapy is controversial. [ncbi.nlm.nih.gov]

  Modified surgical procedures in intestinal tuberculosis. Br J Surg. 1979;66:180-1. Vagholkar KR. Abdominal Tuberculosis. Bombay Hospital J.1995;37(3):441-5. [ijmedicine.com]

  On the other hand, diagnosis of nodal TB was confirmed from surgical procedures or percutaneous biopsy in 6 patients (confirmed diagnosis), while 1 patient was diagnosed based on clinical response to anti-TB agents and computed tomography imaging (clinical [bmcinfectdis.biomedcentral.com]

  Earlier, a minimally invasive surgical procedure such as laparotomy was the only definitive diagnostic approach. [saudijgastro.com]

• Malnutrition

  The latter can happen due to decreased immunity levels like in the case of severe infections, HIV, malnutrition etc. [medindia.net]

  Subgroup analysis and investigation of heterogeneity Death from abdominal TB can be related to mycobacterial burden and dissemination of infection, malabsorption, malnutrition, co‐morbidities, and complications of the disease and treatment. [cochranelibrary.com]

  On general examination, anemia was detected in 36 patients (79%), malnutrition in 32 (70%), and cervical lymphadenopathy in two (4%) patients. [jgid.org]

  As most patients were from a low socioecomomic strata, it is possible that malnutrition (and the resultant decrease in cell mediated immunity, fibrosis, and healing) was a factor in the pathogenesis and increased frequency of perforation in abdominal [jlponline.org]

• Abdominal Pain

  Case 2 A 38-year-old male with a two-week history of moderate epigastric abdominal pain and 38ªC fever. Physical examination found pain in the epigastrium followed by rebound tenderness. [sages.org]

  Most patients presented with abdominal pain and ascites (22 cases), abdominal pain without ascites (four cases) and mixed forms of fibroadhesive type with multiple interloop cysts (two cases). [saudijgastro.com]

  Presenting features Abdominal pain was the predominant presenting feature. Fourteen patients reported a history of generalised abdominal pain. [nzma.org.nz]

  Their usual presentation includes abdominal pain, weight loss, anemia, and fever with night sweats. Patients may present with symptoms of obstruction, hemorrhage, perforation right iliac fossa pain, or a palpable mass in the right iliac fossa. [omicsonline.org]

  In intestinal tuberculosis abdominal pain, constipation and vomiting suggestive of intestinal obstruction are usually seen. Recurrent attacks of subcute intestinal obstruction occur. [oapublishinglondon.com]

• Abdominal Mass

  […] and intestinal serosa; abdominal lymphadenopathy and intra-abdominal mass lesions. [academic.oup.com]

  Appendicular mass 4. Lymph node mass 5. Psoas abscess 6. [slideshare.net]

  In contrast, the detection of abdominal masses by physical examination was noted in only 10.15% of our patients. [dovepress.com]

  In patients with palpable abdominal masses, direct fine needle aspiration cytology can also be applied[ 5 ]. This method is not feasible in any of our patients because we could not palpate these masses in any of them. [wjgnet.com]

  CT scan and ultrasonography were carried out in 9 and 6 patients respectively and they revealed evidence of ascites, peritoneal thickening and abdominal masses. [jpma.org.pk]

• Confusion

  The abdominal tuberculosis is known for its varied and confusing symptomatology whereby it mimics closely with various other similar diseases like inflammatory bowel diseases [ 18 – 19 ]. [intechopen.com]

  The clinical picture of small intestinal and colon TB can be confused with IBD, ileocecalactinomycosis, and malignancies; but in individuals from developing countries, chronic parasitic diseases including amebiasis, schistosomiasi, and strongyloidiasis [najms.org]

  To avoid confusion, we classified peritonal TB into two types, the wet and dry type (fixed fibrotic and dry plastic type). Nodal TB was divided into mesenteric, porta hepatitis, celiac axis, peripancreatic, and combined. [bmcinfectdis.biomedcentral.com]

  It may be confused with several different conditions such as inflammatory bowel disease, cancer and other infectious diseases. [scielo.br]

Diagnostic workup confirming the diagnosis of abdominal TB is outlined in [Table 4]. [najms.org]

Results Of the total study subjects, 266 patients were chosen for diagnostic laparoscopy based on the fact that their findings and symptomatology were so vague that a conclusion could not be drawn from the clinical examination and the usual laboratory workup [intechopen.com]

Figuras y tablas - Figure 1 Diagnostic workup of HIV‐positive individuals with suspected abdominal tuberculosis or disseminated tuberculosis with abdominal involvement Figuras y tablas - Figure 2 Study flow diagram. [cochranelibrary.com]

Treatment failure: failure to improve with antituberculous treatment, or deterioration following initial improvement while on antituberculous treatment. [cochranelibrary.com]

[…] of the disease after the end of treatment. [cochrane.org]

Most of the guidelines on the treatment of tuberculosis suggest that 6 months treatment is sufficient for extrapulmonary tuberculosis except for bone tuberculosis and tubercular meningitis. [clinicaltrials.gov]

The treatment(oral ATT) was stopped after a year. However the pain, and the original symptoms reappeared after 2 months. This time the treatment was the same, also the streptomycin injection was given for 60 days. [doctor.ndtv.com]

Average treatment in this group was significantly longer than for ATB involving other sites (10 vs 7.3 months, p=0.04). Conclusions Laparoscopic biopsy should be performed if possible. Treatment times often exceed 6 months. [erj.ersjournals.com]

Large bowel tuberculosis and possible influencing factors for surgical prognosis: 30 years’ experience. World J Surg. 1997;21:500-4. Bernhard JS, Bhatia G, Knauer CM. Gastrointestinal Tuberculosis J Clin Gastrenterol. 2001;1:397-402. [ijsurgery.com]

It lends itself to a wide ranging differential that can include infection, inflammatory bowel disease and malignancy. 3 Prompt and accurate diagnosis leads to earlier tuberculosis treatment, which creates advantages not only with regard to patient prognosis [nzma.org.nz]

In our study population, most patients with abdominal TB showed a good response to anti-TB agents and had a good prognosis. [bmcinfectdis.biomedcentral.com]

Perforations were present both proximal to and at the site of the stricture, as reported. [4], [15], [17], [18] Multiple perforations occur in 40% of the patients and are associated with a poor prognosis. [15] Acid fast bacilli by Ziehl Neelsen stain [jlponline.org]

[…] peritoneal tuberculosis remains as a challenge due to the wide range of clinical presentations, nonspecific laboratory findings and superimposition of imaging findings with other diseases, particularly with peritoneal carcinomatosis, whose treatment and prognosis [scielo.br]

Etiologic diagnosis required histopathological and bacteriological analysis. Endoscopy and laparoscopy play a key role in taking samples for biopsy [4], [7], [13], [14], [15]. [medwave.cl]

[…] strongyloidiasis are often considered the top priorities in the differential diagnosis. [15] Crohn's disease is uncommon in certain developing countries [16] and, therefore, in patients from those countries with the clinical picture of IBD, a tuberculous etiology [najms.org]

The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and [ingentaconnect.com]

Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut 1992; 33:1085-8. 7. Bernardo J. Epidemiology and pathology of extrapulmonary and miliary tuberculosis, 2014. [najms.org]

Abdominal tuberculosis: epidemiologic profile and management experience of 233 cases. J Pak Med Assoc. 2012;62(7):704-7. Palmer KR, Patil DH, Basran GS, Riordan JF, Silk DB. Abdominal tuberculosis in urban Britain-a common disease. [ijsurgery.com]

Recent epidemiological work is reviewed, and its relationship to these changes considered. The distribution of disease along the gastrointestinal tract and in the mesentery is discussed. [karger.com]

Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut. 1992 Aug;33(8):1085-8. Findlay JM, Addison NV, Stevenson DK, Mirza ZA. [ijmedicine.com]

In: Gastrointestinal and liver disease: pathophysiology/ diagnosis/ management. Feldman M, Friedman LS, Sleisenger MH (Eds), Vol 2, 7th Edition, Saunders Publishers, China, 2002, pp. 1864-1913. 6. Bolukbas C, Bolukbas FF, Kendir T, etal. [ispub.com]

[…] source=machineLearning&search=pathophysiology+of+abdminal+tb&selectedTitle=1%7E150§ionRank=1&anchor=H2#H7622739. ) 8. Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 1993;88:989-99. 9. [najms.org]

PATHOPHYSIOLOGY OF ABDOMINAL TB There are several ways by which tuberculosis can involve abdomen (Table 1 )[ 10, 11 ]. Firstly, the tubercle bacilli may enter the intestinal tract through the ingestion of infected milk or sputum. [ncbi.nlm.nih.gov]

Further studies are needed to increase our confidence as to whether six-month regimens are as good as nine-month regimens for preventing relapse ; and to provide information about treating abdominal TB in children and in people with HIV. [cochrane.org]

Given the correlation of peritoneal tuberculosis and elevated CA-125 levels, prompt diagnosis may prevent unnecessary laparotomies. Back to 2018 Program [afmr.org]

Park K, Park’s textbook of Preventive & Social Medicine. 19th ed India M/S Banarasidas Bhanot. 2007: 768. Kapoor VK, Abdominal tuberculosis. The Indian contribution. Indian J Gastroenterol. 1998;17:141-7. [msjonline.org]

Adhesions between the bowel loops prevent free perforation but promote formation of intestinal fistulae. Unlike the ulcerative form, hypertrophic intestinal tuberculosis commonly occurs in relatively well-nourished patients. [patientcareonline.com]

Therefore, a high index of suspicion is required to make a prompt diagnosis and to start antituberculous therapy, which is essential to limit complications and prevent death ( Balasubramanian 1997 ; Lazarus 2007 ). [cochranelibrary.com]