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PubMed1987

The varied manifestations of abdominal tuberculosis.

Eight cases of abdominal tuberculosis from the Department of Medicine, Singapore General Hospital are reported to illustrate the varied clinical manifestations of the disease. Presentation ranged from asymptomatic hepatomegaly to acute abdomen (intestinal obstruction/perforation). Chronic non-specific symptomatology (fever, weight loss, abdominal pain, diarrhoea, jaundice) was commonest. There were three patients with hepatic tuberculosis, two with tuberculous mesenteric lymphadenitis and three with intestinal tuberculosis, two of whom had concomitant tuberculous peritonitis. Only three patients had coexisting pulmonary tuberculosis. The diagnosis was unsuspected at presentation in four patients. Initial provisional diagnoses included typhoid, abdominal lymphoma, hepatic malignancy, chronic hepatitis and iatrogenic gut perforation. All patients responded totally to conventional antituberculous therapy.

Adult↗
PubMed1987

Abdominal tuberculosis in children. A survey of cases at the Red Cross War Memorial Children's Hospital, 1976-1985.

Fifty-nine cases of abdominal tuberculosis were seen at the Red Cross War Memorial Children's Hospital, Cape Town, during the period 1976-1985. More than half these patients were under 4 years of age and all were malnourished. Mesenteric adenitis and/or peritoneal involvement accounted for the majority of cases and only 8 patients with proven gastro-intestinal lesions were seen. The diagnosis of suspected abdominal tuberculosis is relatively easily made since abdominal distension occurs in almost all patients. More than half have an abdominal mass, a chest radiograph suggestive of tuberculosis, a positive Mantoux skin test or a combination of these as supportive evidence for the diagnosis. Over a quarter of the patients presented with signs suggestive of intestinal obstruction. Response to antituberculosis therapy is excellent. Stricture formation on healing may occur in a minority of patients with the enteric form of the disease. Providing it is not part of disseminated tuberculosis in a grossly malnourished young child, the prognosis with treatment for abdominal tuberculosis is satisfactory.

Age Factors↗
PubMed1985

Intestinal tuberculosis: bacteriological study of tissue obtained by colonoscopy and during surgery.

The biopsy tissue obtained during surgery and colonoscopy from 28 cases of intestinal tuberculosis was utilized for isolation and identification of mycobacteria. The mycobacteria could be isolated in 12 (42%) of 28 patients. Colonoscopy can be a successful method of bacteriological diagnosis of intestinal tuberculosis. Mycobacteria were scarcely ever seen on histological sections. Combined use of guinea pig inoculation and culture was more rewarding than either alone. The yield of positive cultures was greater in tissue with caseation necrosis, though organisms were also recovered from tissues showing non-caseating granuloma and non-specific inflammation. The intestinal tissue gave more positive cultures (41%) than did lymph nodes (14%). The organisms were isolated in patients with or without pulmonary lesions and chemotherapy in the past. All the organisms were isolated as Mycobacterium tuberculosis.

Adolescent↗