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QJM Advance Access published online on January 30, 2008
QJM, doi:10.1093/qjmed/hcm125
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Abdominal tuberculosis in a district general hospital: a retrospective review of 86 cases

J. Ramesh1, G.S. Banait1 and L.P. Ormerod2,3

From the 1Department of Gastroenterology and 2Department of Chest Medicine, Royal Blackburn Hospital, Blackburn, Lancs BB2 3LR and 3Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, Lancs PR1 2HE, UK

Address correspondence to Prof. L.P. Ormerod, Chest Clinic, Royal Blackburn Hospital, Blackburn, Lancashire BB2 3HH, UK. email: lawrence.ormerod{at}elht.hs.uk

Received 6 June 2007 Accepted for publication 12 September 2007.


  Abstract

Background: Abdominal tuberculosis (ATB) is a great mimic and an important cause of morbidity. Its incidence is more common in certain groups.

Aim: To review the cases of ATB in Blackburn from 1985 to 2004, with emphasis on presentation, investigation, diagnosis, treatment and follow-up.

Methods: A retrospective cases note analysis from a prospectively compiled database.

Results: Eighty-six cases of ATB were on a prospective database of all tuberculosis (TB) cases in Blackburn for 1985–2004 inclusive. Full case papers were available for 82 and partial data for the remaining four cases. Median age was 34.8 years, with an equal sex distribution. South Asians accounted for 91% of cases. The highest proportion of patients had peritoneal TB, and a considerable number (27%) had TB at multiple sites.

Conclusions: The diagnosis can be difficult to make because of the varied presentation, the low percentage with positive microscopy for acid-fast bacilli and the time delay of up to several weeks for a positive TB culture. The thresholds for laparoscopy and/or laparotomy for the diagnosis were therefore very low. The diagnosis could be made rapidly by these methods, and early treatment instituted. Six months short-course chemotherapy is very effective in ATB. This should be changed, if appropriate, on the basis of drug susceptibility data.


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