Abdominal Tuberculosis In Children Research Articles

An important diagnosis of ascites and abdominal mass coexistence in a child: Peritoneal tuberculosis

Tuberculosis is still a life-threatening disease worldwide, particularly in developing countries. Miliary tuberculosis is an important diagnosis in children which needs urgent treatment. A 15-year-old male patient was investigated for an abdominal mass with the symptoms of chronic abdominal pain, weight loss, and ascites. On ultrasonography, a 4.5x4x4 cm sized mass that could not be differentiated whether cystic or solid was defined at left paraumbilical region. During laparotomy, widespread punctate granulomas were seen on the intestinal surfaces, peritoneum, and thickened omentum. Tissue biopsies were taken with preliminary diagnosis of possible tuberculosis. The pathological examination was compatible with granulomatous inflammation involving caseous necrosis. In conclusion, miliary tuberculosis with abdominal involvement is a rare type of the disease and can also be seen in pediatric patients without lung tuberculosis. Percutaneous sampling of ascites fluid may not be enough for the diagnosis. Tissue sampling is the most appropriate method for diagnosis and timely treatment for abdominal tuberculosis in children.

Abdominal Tuberculosis in Children: A Case Series of Five Patients

Tuberculosis remains (TB) to be one of the most common causes of child morbidity and mortality. Abdominal TB is not frequently diagnosed and, although its incidence is not definitively established, there are data that seem to indicate that it accounts for approximately 1-3% of all pediatric TB cases and for no more than 10% of those with extrapulmonary manifestations. It seems, however, that abdominal TB is significantly more common than usually thought as signs and symptoms are non-specific and may mimic other diseases. The delayed or wrong diagnosis of pediatric abdominal TB can have dramatic consequences as they can lead to untreated TB with miliary dissemination, unnecessary surgery, or dangerous drug therapies. This report describes five cases of abdominal TB diagnosed among 216 pediatric patients admitted for TB in Italy from 2011 to 2021. Our cases evidence that abdominal TB is a complex and potentially very severe disease that, when not appropriately diagnosed, may be associated with severe complications and prolonged anti-TB therapy. Discussion among specialists is crucial to achieve an early diagnosis and to promptly start the anti-TB treatment. Further studies are needed to clarify the appropriate duration of therapy as well as management of MDR abdominal TB cases.

Abdominal Tuberculosis in Children: A Case Report Demonstrating the Role of Imaging

Abdominal Tuberculosis in Children: A Case Report Demonstrating the Role of Imaging

Abdominal tuberculosis in children

To determine the features of diagnosis and clinical course of abdominal tuberculosis in children. Eighteen children aged from 5 days to 16 years with abdominal tuberculosis have been followed-up throughout 50 years. Diagnostic process implied anamnesis, objective examination, laboratory data and specific samples, ultrasound, X-ray examination, MRI, CT and morphological examination of specimens. Intestinal form was diagnosed in 2 children with abdominal tuberculosis, mesadenitis - 3 patients, liver tuberculosis - 4 ones, tuberculosis of uterine appendages - 3 patients, peritonitis - 6 ones. CT of the abdomen, diaskintest and morphological examination were the most important diagnostic methods. Laparotomy was performed in 16 children. Five cases are decsribed. Abdominal tuberculosis in children is mostly secondary. Several anatomical regions are simultaneously involved in specific process. Isolated lesion of one abdominal organ is rare. Active tuberculosis of respiratory organs in pregnant women has a significant negative impact on the fetus and newborns.

Abdominal Tuberculosis in Children: Challenges, Uncertainty, and Confusion.

The diagnosis of abdominal tuberculosis (TB) is challenging, and the prevalence of abdominal TB in children is likely underestimated. It may present with nonspecific abdominal symptoms and signs, but children who present with pulmonary TB may have additional abdominal subclinical involvement. Diagnosis is specifically challenging because none of the available diagnostic tools provide adequate sensitivity and specificity. In this review, we summarize the best available evidence on abdominal TB in children, covering the epidemiology, pathogenesis, clinical presentation, diagnosis, and treatment. We propose a diagnostic approach that could be followed for symptomatic children. We believe that a combination of investigations could be useful to both aid diagnosis and define the extent of the disease, and we propose that abdominal ultrasound should be used more frequently in children with possible TB and any abdominal symptoms. This neglected disease has received little attention to date, and further research is warranted.

Abdominal tuberculosis in children: A real-world experience of 218 cases from an endemic region.

Background and AimAbdominal tuberculosis (ATB) in children poses a diagnostic challenge because of its nonspecific clinical features, which often delay the diagnosis. Our aim was to present our real‐world experience and provide an insight into the presentation, pattern of distribution, and diagnosis of the disease.MethodsA retrospective review was conducted of case records of all children ≤12 years of age diagnosed with ATB from January 2007 to January 2018. Clinical details and investigations were recorded and analyzed.ResultsA total of 218 children (110 boys), with a median age of 10 (0.25–12) years, were included. There was a median delay of 4 (0.5–36) months in establishing the diagnosis. Abdominal pain, fever, and loss of weight were the most common presenting features, with the triad of symptoms present in 54%. Multiple intra‐abdominal sites were involved in 118 (54%) patients, with a combination of the gastrointestinal tract (I) and abdominal lymph nodes (L) being the most common (53/118). Among children with single‐site involvement (n = 100), the most commonly involved was L in 39 (39%), followed by I in 35(35%). Loss of weight was more common in children with involvement of multiple sites (85/118 vs 60/100, P = 0.03). Overall, a confirmed diagnosis was possible in 94 participants (43.1%). Suggestive imaging had the highest diagnostic yield of 85%. Nine (4.1%) patients needed surgical management.ConclusionA triad of abdominal pain, fever, and weight loss is suggestive of ATB. Multiple intra‐abdominal sites are frequently involved. Microbiological confirmation is possible in only one‐third of the cases.

Obstructing jejunal stricture from tuberculosis

Abstract Abdominal tuberculosis in children is a great masquerader. Due to varied clinical presentation, diagnosis is challenging. Although peritoneal and nodal disease is the most common presentation but jejunal involvement is seen in widespread disease. Isolated jejunal stricture is extremely rare. We are presenting a case of 8 year old female child presented with intermittent bilious vomiting, constipation and inability to tolerate solid and semisolid food. Diagnosis was confirmed as isolated tubercular jejunal stricture after investigations and surgery.

Sonographic Findings of Abdominal Tuberculosis in Children With Pulmonary Tuberculosis.

Ultrasound reports of 102 children with microbiologically confirmed or clinically diagnosed pulmonary tuberculosis (TB) showed that 23 of 37 (64%) and 23 of 65 (36%) had TB suggestive abdominal lymphadenopathy, and 16 of 37 (44%) and 8 of 65 (13%) had splenic microabscesses, respectively. Splenic microabscesses were associated with HIV infection (P = 0.041). These data suggest that pulmonary TB is often complicated by abdominal TB in children.

Abdominal Tuberculosis in Children—Imaging and Intervention

The global burden of tuberculosis (TB) is a health care challenge in both the developing and developed world. Children represent a high-risk group for acquiring the disease, but despite this, abdominal TB (ATB) remains uncommon. ATB includes infection of the gastrointestinal tract, peritoneum, mesentery, lymph nodes, and solid organs. Mycobacterium tuberculosis accounts for most cases but Mycobacterium bovis has also been implicated. The clinical manifestations of ATB are nonspecific leading to diagnostic delay that results in significant morbidity and mortality. Imaging plays a crucial role in the early diagnosis of TB, guides biopsy, evaluates response to treatment, and identifies complications. In this article, we review the imaging findings of ATB with particular reference to modalities that avoid the use of radiation in pediatric patients. The role of interventional radiology and surgery in the diagnosis and management of ATB is also described.

Abdominal tuberculosis presenting as mass per abdomen: a case report

Tuberculosis (TB) can involve any part of the gastrointestinal tract, the peritoneum, lymphnodes and the pancreatobiliary system. The primary site of TB is usually lung, from where it disseminates to other parts of the body. TB of the gastrointestinal tract is the sixth most frequent form of extrapulmonary tuberculosis. The incidence of abdominal tuberculosis in children in India is estimated to be 2.2 million as in the year 2014 and India has the world’s largest tuberculosis cases of around 26%. It can have a varied presentation and can mimic any abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Here we present a case of abdominal tuberculosis who presented as mass per abdomen.

Abdominal Tuberculosis in Children: Experience in a Tertiary Hospital in Mexico City

Abdominal Tuberculosis in Children: Experience in a Tertiary Hospital in Mexico City

English

OBJECTIVE: The aim of this study was to evaluate the clinic-pathological profile of children with abdominal tuberculosis. METHODS: A prospective study of children who presented with abdominal tuberculosis was conducted over a period of one year. Diagnosis was made on the basis of clinical profile, supportive investigations and gross morphological findings at surgery and proven caseating granulomas on histopathology. Antitubercular treatment was prescribed to all patients for 1 year. Patients were followed up till completion of ATT. RESULTS: Out of 21 patients, fourteen (66%) children presented within six weeks of their symptoms. The symptoms were loss of weight 19 (90.47%), pain abdomen 18 (85%), loss of appetite 16 (76.19%), fever 14 (66%) and altered bowel habit in five (23%) patients. The physical findings were palor and malnutrition 19 (90%), abdominal distension 60 (76.16%), pyrexia 14 (66%), peritonitis ten (47.64), ascitis five (23%), lump two (19.4%) and abnormal breath sound ten (47%). The supportive investigations were found supporting the diagnosis were proven histopathology 12(80%), lymphocytosis 14(66.6%), raised ESR 14(66%), positive mantoux 10(47.62%), and abnormal abdominal x-ray eight patients (38%). Resection and ileostomy was performed in two (13%) of cases. CONCLUSION: Children who present with abdominal pain for variable period of time should raise high index of suspicion for abdominal tuberculosis. Clinical presentation of abdominal tuberculosis in children is usually nonspecific in nature and often requires laparotomy. During emergency surgery bypass operation and life saving measures in form of lleostomy, gives satisfactory results.

Correction: Abdominal Tuberculosis in Children and Adolescents: to this Day a Diagnostic Challenge

Correction: Abdominal Tuberculosis in Children and Adolescents: to this Day a Diagnostic Challenge

Abdominal Tuberculosis in Children and Adolescents: to this Day a Diagnostic Challenge

Corrected by: Correction: Abdominal Tuberculosis in Children and Adolescents: to this Day a Diagnostic ChallengeKlin Padiatr 2013; 225(01): e1-e1DOI: 10.1055/s-0032-1323766

Macronodular hepatosplenic tuberculosis

Hepatosplenic involvement is a rare manifestation of abdominal tuberculosis in children. We describe the case of a 7-year-old girl with persistent fever, cough, and hepatosplenomegaly. Typical lesions were shown in the liver and spleen by ultrasound and computed tomography. Colonoscopy showed a nodular, ulcerated mass that partially obstructed the cecum. Microbiological and histopathological findings of intestinal and liver biopsy confirmed the clinical suspicion of tuberculosis.

Jejunal tuberculosis in a 10-year-old girl

Abdominal tuberculosis in children usually presents with involvement of the peritoneum, lymph nodes or gastro-intestinal tract. Disease of the gastro-intestinal tract is commonest in the ileocaecal region. A 10-year-old girl presented with abdominal pain and fever of 15 days duration. Abdominal CT detected dilated small bowel loops with enlarged mesenteric nodes and barium meal follow-through demonstrated a small annular stricture in the jejunum, suggestive of jejunal tuberculosis. She was treated with anti-tuberculous chemotherapy and corticosteroids, to which she made a good response. Tuberculosis of the jejunum is rare in children.

Umbilical Signs of Peritoneal Tuberculosis in Children

To report the observation of involvement of the umbilicus with alteration of its morphology in association with peritoneal tuberculosis. This is a retrospective observational case series of abdominal tuberculosis (ATB) in children, treated in the department of pediatric surgery of a tertiary-care children's hospital in the period from January 2004 through April 2010. Out of a total of 38 cases of ATB in children, 22(57.9%) were of the peritoneal type, 14(36.8%) were of the intestinal type, and 2(5.3%) involved the mesenteric lymph nodes. Of the patients manifesting with peritoneal tuberculosis, 11 cases (50%) had involvement of the umbilicus with changes in the umbilical shape and appearance. In seven cases the umbilicus was found retracted and transversely oriented (a slit-like "smiling" appearance) with loss of the umbilical hollow. In two cases there was puckering of the umbilicus. Other findings included umbilical erythema with inflammation in one patient and a fecal fistula at the umbilicus in another patient. While seven cases responded to treatment with antituberculous therapy (ATT), four cases underwent surgery (two laparotomy and two laparoscopy). Findings were similar in all four patients, consisting of adhered dilated bowel loops studded with tubercles which also covered the parietal peritoneum and the falciform ligament. All four cases responded to postoperative ATT. Morphological changes of the umbilicus can provide an additional clue to the diagnosis of peritoneal tuberculosis in children.

Abdominal tuberculosis in children: case series

Abdominal tuberculosis in children: case series

Abdominal Tuberculosis in Children: A Diagnostic Challenge

Abdominal tuberculosis (TB) is a rare manifestation of childhood TB. Abdominal TB is characterized by long-lasting abdominal symptoms, which are usually confused with other conditions, and the diagnosis is usually delayed. During a 5-year period, we identified 10 cases of abdominal TB in a tertiary care children's hospital. Data including demographic characteristics, presenting symptoms, history of Bacille Calmette-Guérin vaccination, lesion sites, laboratory data, image findings, diagnosis, tuberculin skin test, risk factors, treatment, and outcome were collected and analyzed. There were six female patients and four male patients, with a mean age of 14.7 years. One patient died due to the complication of disseminated TB with a pneumothorax. Household members with TB could be traced in six (60%) patients. The most common clinical presentations included fever (9/10), abdominal pain (8/10), and weight loss (8/9). The diagnosis of abdominal TB was suspected initially in only three patients; the others were not diagnosed until 7-36 days (mean=19 days) after hospitalization. The abnormal abdominal image findings, by either computed tomography or ultrasound, included lymphadenopathy (7/9), high-density ascites (6/9), thickening of the omentum or peritoneum (6/9), inflammatory mass (3/9), bowel wall thickening (1/9), and liver abscess (1/9). The chest radiography was abnormal in nine patients. Mycobacterium tuberculosis was isolated from ascites in two out of four patients, gastric aspirates in three, sputum in three, and intra-abdominal tissue specimens in two. Laparotomy was performed in three patients, laparoscopy in one, and colonoscopy in one. In Taiwan, abdominal TB should be considered in patients with fever, abdominal pain, weight loss, and abnormal chest radiography. Characteristic computed tomography findings of abdominal TB and a history of exposure to TB contribute to the diagnosis.

Abdominal Tuberculosis in Children

Abdominal tuberculosis (TB) includes infection of the gastrointestinal tract, peritoneum, mesentery, abdominal lymph nodes, liver, spleen, and pancreas. The most common forms of abdominal TB in children are adhesive peritonitis and nodal disease. We report our experience with abdominal TB treated in our hospital from 1995 to 2008. Thirteen patients (3 boys and 10 girls) of mean age 9.8 years were diagnosed as having abdominal TB. Eight patients presented with abdominal distension and abdominal pain. Fever was seen in 4 patients. One patient had surgical abdominal pain and 2 had abdominal mass. Two patients had coexisting pleural effusion and 1 of them had multifocal TB. Abdominal TB involved peritoneum in 9, abdominal lymph nodes in 7, gastrointestinal tract in 3, spleen in 2 patients, and liver in 1. Ascitic fluid analysis of 9 patients showed exudative fluid with predominately lymphocytes. Laparotomy was performed in 3 patients. The diagnosis of abdominal TB was confirmed histopathologically in 5 patients and microbiologically in 3. The remaining patients had been diagnosed by ascitic fluid diagnostic features, abdominal imaging, tuberculin skin test, history of exposure, and a positive response to antituberculous treatment. Twelve patients completed the antituberculous therapy without any complications. One patient with multifocal TB had neurological sequelae. In the areas with a high prevalence of tuberculosis and confirmatory investigations are inadequately available, treatment may be initiated, based on strong clinical diagnosis and supportive investigations. In such situations, it is the response to therapy that indirectly proves the diagnosis.