Abdominal Tuberculosis

70% of patients withadvanced pulmonary disease acquired

gastrointestinal tuberculosisfrom swallowing infectious secretions

Main types

• GI TB• Mesenteric lymph

node TB• Retroperitoneal

cavity TB• Peritoneal TB

Symptoms

• Abdominal pain• Nausea• Loss of appetite• Low grade fever• GI dysfunction• Ascites• Diarrhea• Constipation

Esophagus

• From adjacent casous node

Stomach

• Ulcerative, gastric outlet obstruction• Duodenal disease causes same symptoms

Small Bowel

• Perforation, obstruction, fistula, hemorrhage, malabsorption

Ileocecal Area

• Typical site of TB• Pain• Anorexia• Diarrhea• Palpable mass

Tuberculous peritonitis results either from spread of adjacent tuberculous disease such as an abdominal lymph node, intestinal focus, orfallopian tube, or during miliary tuberculosis.

Symptoms

• Ascites• Weight loss• Abdominal pain• Fever

Peritoneal fluid is exudative, with high amount of lymphocytes

Diagnosis

• Anamnesis• Biochemistry test• Endoscopy• Biopsy• Mantoux test• Chest X-ray• Abdominal X-ray• Ultrasound• Ascitic fluid examination

Anemia, raised ESR, hypoalbumenemia, leucopenia with relative lymphocytosis, normal serum transminase level

Differential Diagnosis• Malabsorption

- Coeliac disease - Lymphoma - Immunoproliferative small intestinal disease

• Mass - Appendicular mass - Crohn’s disease - Carcinoma - Lymphoma

• Ascites - Cardiac disease - Renal disease - Hepatic disease