Abdominal tuberculosis in children: an Indian experience

Area of Science:

• Pediatrics
• Infectious Diseases
• Gastroenterology

Background:

• Abdominal tuberculosis (TB) in children presents diagnostic challenges due to non-specific symptoms.
• Early diagnosis is critical for effective management and improved outcomes in pediatric abdominal TB.

Purpose of the Study:

• To analyze the clinical patterns of abdominal TB in children.
• To evaluate the diagnostic utility of various investigations for pediatric abdominal TB.
• To assess treatment outcomes and the role of laparotomy.

Main Methods:

• Retrospective analysis of hospital records of 125 children (≤14 years) treated for abdominal TB.
• Review of presenting symptoms, clinical findings, laboratory investigations, and radiographic studies.
• Evaluation of treatment strategies including conservative management with anti-TB drugs and surgical intervention (laparotomy).

Main Results:

• Abdominal pain was the predominant symptom (80%), with ascites (44%) and visible peristalsis (36%) also noted.
• Non-invasive investigations were often inconclusive; diagnosis was confirmed by clinical response to chemotherapy in 36% of cases without tissue diagnosis.
• Fifty percent of patients received conservative management, while others underwent laparotomy for diagnosis and obstruction relief, with no post-operative mortality and good recovery.

Conclusions:

• Pediatric abdominal TB exhibits non-specific characteristics, making non-invasive diagnostic methods frequently insufficient.
• Laparotomy is often necessary for definitive diagnosis and management of bowel obstruction in pediatric abdominal TB.
• In endemic regions, a high index of suspicion coupled with a therapeutic trial of anti-TB chemotherapy is warranted for suspected cases.