Abdominal tuberculosis in patients with acute abdomen: an observational single centre study

Abstract

Background: Abdominal tuberculosis tends to present with nonspecific features and can be hard to diagnose. Abdominal tuberculosis can mimic a variety of other abdominal conditions and only a high degree of suspicion can help in the diagnosis, otherwise, it is likely to be missed or delayed resulting in high morbidity and mortality. Therefore, a high index of suspicion, fortified with a general degree of awareness and knowledge of this form of the disease is essential. Methods: A careful history taking, and thorough clinical examination was carried out in each case. All the patients were investigated. Some of the patients needed surgical intervention. For patients who responded favorably to conservative management and did not require surgery, diagnostic studies were carried out to confirm the presence of abdominal tuberculosis. Results: Abdominal tuberculosis constituted a significant percentage (23.6%) of all cases attending the emergency with an acute abdomen. Ultrasound and CECT can show various findings which can be suggestive of abdominal tuberculosis, but there is no significant difference in PPV of ultrasound and CECT abdomen. Colonoscopy has PPV of 55.6% in diagnosis of abdominal tuberculosis. Gene Xpert is significantly better than AFB staining in diagnosing the abdominal tuberculosis with ascitic fluid examination. Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and prompt management of this curable disease. Ultrasound and CECT can be suggestive of abdominal tuberculosis, but final diagnosis can be made only after histopathological examination/with gene Xpert report.