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PubMedDate not supplied

Abdominal tuberculosis in Cairo, Egypt.

Twenty-two abdominal tuberculosis patients seen at Abbassia Fever Hospital in Cairo, Egypt from January 1990 to August 1992 are described; their mean age was 21.5 years, range 9-54 years; 17 were female. Common symptoms were fever, malaise, abdominal pain (64%) and weight loss (82%). Chest X-rays were normal in 14 patients (64%), but ultrasonography/computerized tomography of the abdomen was abnormal in 20 patients (91%), with adenopathy the usual finding. Anaemia and a raised erythrocyte sedimentation rate were present in all patients, and purified protein derivative skin test (5 Tu) was positive in 82%. Predominant abnormal physical findings were abdominal (86%), including hepatomegaly/splenomegaly and abdominal mass. Diagnosis was made from biopsy material (caseating granulomas) in 6 patients by laparotomy, 1 by laparoscopy, and 3 by cervical or supraclavicular node biopsy; and from laboratory examination of excretions in only 4 patients (acid-fast bacilli in stools of 2, mycobacteria in urine and menstrual fluid). Eight patients required presumptive diagnosis after response to specific isoniazid (+ethambutol) antituberculous therapy.

Adolescent↗
PubMed1975

Tuberculosis of the abdomen in Ibadan: a clinico-pathological review.

An account is given of the age distribution and clinical features of 178 patients suffering from abdominal tuberculosis who were treated in the University College Hospital, Ibadan, Nigeria. The importance of peritoneal biopsy and laparotomy in diagnosis is discussed. The main findings at necropsy are described. The importance of early diagnosis is stressed.

Adolescent↗
PubMed1986

Serodiagnosis of intestinal tuberculosis by enzyme immunoassay and soluble antigen fluorescent antibody tests using a saline extracted antigen.

The efficacy of enzyme-linked immunosorbent assay (ELISA) and soluble antigen fluorescent antibody (SAFA) tests in the diagnosis of intestinal tuberculosis was compared using saline extracted surface antigen of M. tuberculosis H37Ra. Of the 24 proved cases of intestinal tuberculosis ELISA detected positivity in 92% compared with 83% detected by the SAFA test. The 2 tests showed a strong correlation with each other and yielded a clear cut difference between patients and controls, although there was some degree of overlap.

Enzyme-Linked Immunosorbent Assay↗
PubMed1991

Two cases of intestinal obstruction caused by tuberculosis--the role of frozen section diagnosis.

Upper intestinal obstruction caused by tuberculosis is relatively rare, and the diagnosis is often missed. Two cases are described that were diagnosed by frozen section during laparotomy. It might be thought that endoscopy would have eliminated these difficulties, but this is not in fact the case. Many laboratory safety codes forbid the use of frozen sections on tuberculous material, but in endemic areas this restriction is not practical. Special facilities are required so that all frozen sections can be handled safely.

Adult↗
PubMedDate not supplied

Unusual cases of intussusception.

Intussusception occurs most commonly in the first five years of life and is classically associated with intense intermittent abdominal pain, vomiting, bloody mucoid diarrhea, and a palpable abdominal mass. These cardinal findings are frequently not present, however, particularly outside the usual age range. The emergency physician must therefore be vigilant in considering intussusception as a potential cause for intestinal obstruction in all patients, if ischemic complications are to be avoided. We present three cases of "unusual" intussusception, and provide a review of this entity and a guide to its consideration and work-up in the emergency department.

Adult↗
PubMed1993

Incidence of abdominal tuberculosis in Bangladeshi migrants in east London.

A retrospective epidemiological study of abdominal tuberculosis in a defined population in the London Borough of Tower Hamlets was conducted between January 1985 and 31 December 1989. The total population of 163,900 included a mean of 20,732 Bangladeshis. Of the 13 cases diagnosed 8 were Bangladeshi, with equal involvement of the peritoneum and intestine. The crude incidence in the Bangladeshi community was 7.7 cases/10(5)/year, which was significantly higher than that in Europeans (0.3 cases/10(5)/year, chi 2 with Yate's correction = 14.0 P < 0.001). The highest age-specific incidence was amongst those aged 16-20 years and 41-45 years. Most patients had a laparotomy or peritoneal biopsy to confirm the diagnosis. The response to therapy was good. Only 62% of cases were notified. This study confirms the importance of tuberculosis in the differential diagnosis of abdominal symptoms in Bangladeshi patients.

Adolescent↗
PubMed1995

Abdominal tuberculosis in Taiwan: a report from Veterans' General Hospital, Taipei.

SETTING: From 1986 to 1992, 27 cases of abdominal tuberculosis were diagnosed in Veterans General Hospital-Taipei, Taiwan, including 21 cases of intestinal tuberculosis and 6 cases of peritoneal tuberculosis. OBJECTIVE: To ascertain the clinical characteristics of abdominal tuberculosis in Chinese patients and the possibility of early clinical diagnosis of abdominal tuberculosis. DESIGN: Clinical features, diagnosis and treatment modality of these 27 cases were reviewed. RESULTS: 22 of the patients (81.5%) had chest X-ray evidence of pulmonary tuberculosis. Only 2 had normal chest X-ray findings. Sputum mycobacterium culture was positive in 14 of 27 patients (51.9%). 20 patients received exploratory laparotomy for the diagnosis and all of the preoperative diagnoses were wrong. The diagnosis was still incorrect or uncertain in 9 cases after laparotomy if no pathological examination was done. Ileocecal area was the most common site of intestinal tuberculosis in our series and 3 of 11 ulcerative types of intestinal tuberculosis died later. CONCLUSION: Due to protean manifestations, the diagnosis of abdominal tuberculosis was frequently misdiagnosed, and particularly as carcinomatosis. The diagnosis should be considered when patients with pulmonary tuberculosis suffer from abdominal discomfort. Exploratory laparotomy is needed in cases suspected of abdominal carcinomatosis without definite diagnosis.

Adult↗
PubMed2006

[Fistula between the urinary bladder and large bowel due to sigmoid tuberculosis].

A sigmoid tuberculosis is very rare. We report a case of sigmoid pseudotumoral tuberculosis with a fistulization into the urinary bladder in a 10-year-old girl. The diagnosis of tuberculosis was made by histopathological examination of the surgical specimen after segmental colectomy. Surgery completed by antitubercular chemotherapy gave a good result.

Child↗
PubMed2005

Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure.

Intestinal tuberculosis is a major problem in many regions of the world. The incidence of it is rising in Western countries due to immigration from Third World countries and human immunodeficiency virus infection. The difference between the simple closure and resection and anastomosis was evaluated in this study. Retrospectively, 12 patients with intestinal tuberculosis diagnosed histopathologically among 50 patients with free intestinal perforations operated on between 1995 and 2003 at Turgut Ozal Medical Center were evaluated. Each patient underwent routine laboratory tests and radiologic studies. The most common symptoms of patients were abdominal pain, night sweats, and weight loss. Sites of perforation were ileum in 10 patients (multiple perforation in 4) and jejunum in 2 patients (both had multiple perforations). The perforation was closed by primary closure in 7 patients. Resection-anastomosis was performed in 5 patients. Leaks occurred in overall 3 of 7 patients with primary closure. Three of the 7 patients with leaks due to septicemia died. The mortality rate among all patients was 25%. Intestinal tuberculosis should be kept in mind as a cause in free intestinal perforations. Because of high mortality rate, the resection of the affected area and anastomosis may be the treatment of choice rather than primary closure.

Adult↗