Reappraisal of abdominal tuberculosis

Tuberculosis, including abdominal tuberculosis, is a common disease responsible for considerable mortality and morbidity. The diagnosis of abdominal tuberculosis requires a high index of suspicion due to its vague symptomatology. This retrospective study (of 3 years duration) was conducted on 84 operated cases in whom a diagnosis of abdominal tuberculosis (excluding genito-urinary) was made on histopathology. These constituted 5.4% of all the surgical material related to gastro-intestinal tract. The mean age of the patient was 23.5 years, with the youngest patient being only 7 months old. No sex predilection was noted (41 males, 43 females). Eighteen patients (21.4%) belonged to the paediatric age group (0-15 years). Majority of patients (92.8%) presented with features of intestinal obstruction. Sixteen patients were already receiving anti-tuberculous treatment. Terminal ileum (49 cases) was the most common site of involvement followed by appendix (9), jejunum (5), anal canal (4), caecum (3) and colon (2). One case of duodenal tuberculosis was also confirmed. The important features noted in this study were high paediatric patient involvement (21.4%), significantly higher incidence of intestinal perforation (69%) and rarity of gastroduodenal tuberculosis (1.2%). Concomitant infections like typhoid and worm infestations were also seen.