Abstract
BackgroundAbdominal tuberculosis (TB) is an uncommon form of infection with Mycobacterium tuberculosis in Korea. In this study, we aimed to highlight the clinical features, diagnostic methods, and outcomes of abdominal TB over 12 years in Southeastern Korea.MethodsA total of 139 patients diagnosed as having abdominal TB who received anti-TB medication from January 2005 to June 2016 were reviewed. Among them, 69 patients (49.6%) had luminal TB, 28 (20.1%) had peritoneal TB, 7 (5.0%) had nodal TB, 23 (16.5%) had visceral TB, and 12 (8.6%) had mixed TB.ResultsThe most frequent symptoms were abdominal pain (34.5%) and abdominal distension (21.0%). Diagnosis of abdominal TB was confirmed using microbiologic and/or histologic methods in 76 patients (confirmed diagnosis), while the remaining 63 patients were diagnosed based on clinical presentation and radiologic imaging (clinical diagnosis). According to diagnostic method, frequency of clinical diagnosis was highest in patients with luminal (50.7%) or peritoneal (64.3%) TB, while frequency of microscopic diagnosis was highest in patients with visceral TB (68.2%), and frequency of histologic diagnosis was highest in patients with nodal TB (85.2%). Interestingly, most patients, except those with nodal TB, showed a good response to anti-TB agents, with 84.2% showing a complete response. The mortality rate was only 1.4% in the present study.ConclusionsMost patients responded very well to anti-TB therapy, and surgery was required in only a minority of cases of suspected abdominal TB.
Highlights
Abdominal tuberculosis (TB) is an uncommon form of infection with Mycobacterium tuberculosis in Korea
Colonoscopy is useful in patients suspected of having intestinal TB, while laparoscopy and biopsy are more useful in peritoneal TB; ascitic fluid analysis is more accessible, its acid-fast bacilli (AFB) culture has a low sensitivity
Definitions and classification Abdominal TB was defined as infection of the luminal tract, peritoneum, intra-abdominal lymph nodes, and/or intra-abdominal solid-organs with M. tuberculosis
Summary
Abdominal tuberculosis (TB) is an uncommon form of infection with Mycobacterium tuberculosis in Korea. Abdominal tuberculosis (TB) is defined as infection of the gastrointestinal tract, peritoneum, abdominal solid organs, and/or abdominal lymphatics with Mycobacterium tuberculosis [1]. Abdominal TB is one Abdominal TB can usually be classified into 4 forms: luminal, peritoneal, nodal, and visceral involving the. The most common forms are luminal (ileocecal area) and peritoneal [11]. The clinical presentation of abdominal TB depends on the site of infection. Diarrhea, bleeding from the luminal tract, intestinal obstruction, fever, and weight loss are frequent features of intestinal TB; ascites and abdominal distension are common manifestations of peritoneal TB [8]. Diagnosis of abdominal TB may vary depending on the site of infection [13]. Colonoscopy is useful in patients suspected of having intestinal TB, while laparoscopy and biopsy are more useful in peritoneal TB; ascitic fluid analysis is more accessible, its acid-fast bacilli (AFB) culture has a low sensitivity
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