Abdominal tuberculosis

Infectious disease affecting the abdominal organs

Abdominal tuberculosis is a form of tuberculosis that affects the abdominal cavity and its associated organs. It is caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs but can spread to other parts of the body, including the abdomen. This condition is a significant health concern in regions where tuberculosis is prevalent.

Pathophysiology

Abdominal tuberculosis can involve various parts of the abdomen, including the peritoneum, gastrointestinal tract, lymph nodes, and solid organs such as the liver and spleen. The infection typically spreads to the abdomen through the bloodstream, lymphatic system, or by direct extension from adjacent infected organs.

Tuberculosis of ileum showing serosal tubercles

The most common form of abdominal tuberculosis is peritoneal tuberculosis, which affects the lining of the abdominal cavity. The gastrointestinal tract is the next most commonly involved site, with the ileocecal region being the most frequently affected area. The infection can lead to the formation of granulomas, caseous necrosis, and fibrosis, which can cause obstruction, perforation, or bleeding.

Clinical Presentation

Patients with abdominal tuberculosis may present with a variety of symptoms, which can be non-specific and mimic other conditions. Common symptoms include:

• Abdominal pain
• Weight loss
• Fever
• Night sweats
• Anorexia
• Diarrhea or constipation

Physical examination may reveal abdominal tenderness, ascites, or palpable masses. In some cases, patients may present with complications such as intestinal obstruction or perforation.

Diagnosis

Diagnosing abdominal tuberculosis can be challenging due to its non-specific symptoms and the need to differentiate it from other abdominal conditions. Diagnostic methods include:

• Tuberculin skin test or interferon-gamma release assays
• Imaging studies such as ultrasound, CT scan, or MRI
• Endoscopic procedures like colonoscopy or esophagogastroduodenoscopy
• Biopsy of affected tissues for histopathological examination
• Microbiological cultures or polymerase chain reaction (PCR) for Mycobacterium tuberculosis

Mycobacterial infection in the duodenum

Treatment

The treatment of abdominal tuberculosis involves a combination of antitubercular therapy (ATT) drugs, which typically include:

• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutol

The standard duration of treatment is usually 6 to 9 months, but it may be extended in cases of drug-resistant tuberculosis or complications. Surgical intervention may be necessary in cases of intestinal obstruction, perforation, or abscess formation.

Prognosis

With appropriate treatment, the prognosis for abdominal tuberculosis is generally good. However, delayed diagnosis and treatment can lead to complications and increased morbidity. Early recognition and management are crucial to prevent long-term sequelae.

Related pages

• Tuberculosis
• Peritoneal tuberculosis
• Gastrointestinal tuberculosis
• Extrapulmonary tuberculosis