Abdominal Tuberculosis in Children

Abstract

Abdominal tuberculosis (ATB) in children is still prevalent in the developing nations with the reported incidence of 0.9–1.95% of all pediatric hospital admissions. The diagnosis of ATB in children is elusive and challenging as there are no distinct clinical signs or symptoms or any specific diagnostic test. The final diagnosis is often made after invasive surgical interventions like laparotomy or laparoscopy. Abdominal tuberculosis is generally due to infection by Mycobacterium tuberculosis and rarely due to Mycobacterium bovis or other atypical mycobacteria. It could be an isolated disease or in association with extraintestinal tuberculosis. The source of infection could be due to ingestion of tubercle bacilli or hematogenous or contiguous spread from other focus. The damage to the tissue occurs through Type IV hypersensitivity reaction where the tubercular bacillus activates the immune system and results in formation of epithelioid granulomas with caseous necrosis of the tissues. The order of involvement of various sites is the ileum, ileocecal region, colon, jejunum, rectum, duodenum, stomach, and esophagus.