Abdominal tuberculosis--a retrospective analysis of 121 cases

From 1960 to 1989, a total of 121 patients with abdominal tuberculosis were treated at this hospital. Ages, at the time of diagnosis, ranged from 14 years to 81 years with a mean of 44 years. There were 86 males and 35 females. No clinical feature was diagnostic, but the leading presenting complaints were abdominal pain (79%) and fever (53%). Chest x-ray showed that 80 patients (69%) had coexisting evidence of pulmonary tuberculosis. Lesions were most commonly located at the ileocecal region (40%). The diagnosis was bacteriologically established in only 39 patients (32%). It was difficult to obtain the definitive diagnosis, most of our patients (91 cases) were diagnosed while undergoing laparotomy with tissue biopsy. Although the principal treatment of abdominal tuberculosis was chemotherapy and operation should be reserved until complications occurred, there were still 96 patients (79%) who underwent surgical procedures. The reasons of high operative rate were the difficulty of early diagnosis and the delay of proper treatment. The common complications of abdominal tuberculosis and the related managements were discussed and the findings in our cases which were helpful in diagnosing abdominal tuberculosis were also presented. Sixteen severely ill patients who died tended to be older, poor nutrition and associated with underlying medical diseases. Abdominal tuberculosis is still persistent in Taiwan, and it must be included in the differential diagnosis of obscure abdominal conditions to avoid diagnostic delay and unnecessary illness and death.