The Renaissance of Abdominal Tuberculosis

Abstract

During the last decade, abdominal tuberculosis (TB) has experienced a renaissance. The number of cases diagnosed in Western European and North American countries has dramatically increased. The reasons for this are multiple and include the appearance of AIDS as a significant disorder and the increased morbidity of peoples across the world with the migration of many people from areas of high incidence of TB to the West. Recent epidemiological work is reviewed, and its relationship to these changes considered. The distribution of disease along the gastrointestinal tract and in the mesentery is discussed. The frequency of involvement at various sites and the clinical symptoms caused by the disease are reviewed. The need to diagnose abdominal TB in the 1990s is considered in detail in areas where the disease had previously been thought rare.

Intra‐abdominal and gastrointestinal tuberculosis

“…Thickened, hyperaemic, occasionally haemorrhagic, inflamed peritoneum Diffuse, white-yellowish uniform (3-5 mm) tubercular deposits on peritoneum, omentum and organs Adhesions between organs and peritoneum patients coupled with histology [18,48,53]. Typical features include caseating granulomas with epitheloid and Langerhans cells and chronic inflammatory changes.…”

“…The management of abdominal TB is aimed at improving the patient's general, nutrition and hydration status [48], medical treatment of the disease [147] and surgical management of complications [148].…”

Laparoscopy in Suspected Abdominal Tuberculosis Is Useful as an Early Diagnostic Method*

“…Tuberculosis remains a significant global threat, with compelling evidence of recent resurgence, not only in endemic areas, but in Western Europe and USA as well 1–3 . Tuberculosis can affect any part of gastrointestinal system and abdomen is the sixth most common site of involvement 3 .…”

Abdominal tuberculosis: a surgical perplexity

“…Final outcome in the intestine is therefore strictures predominantly involving the terminal ileum. 7,8 Morphology of intestinal lesions is determined by the immunological status of the patient. Ulcerative lesions are seen in malnourished individuals whereas hyperplastic lesions are seen in well-nourished individuals.…”

“…Bypass procedures may be considered in a few cases. 8,9 Stricturoplasty is best suited for isolated strictures in the terminal ileum. For cases presenting with intra-abdominal findings of a cocoon the options are very limited.…”