Abdominal tuberculosis

Tuberculosis (TB) is common in both underdeveloped and developing countries and, as a result of HIV, is increasingly seen in the developed world also. The lungs are the most common site of involvement in TB, but the abdomen is a common site of extrapulmonary involvement. Abdominal TB includes involvement of the gastrointestinal tract, peritoneum and lymph nodes. Most patients have a chronic presentation but it may be interspersed with acute attacks caused by complications. It often presents with subacute intestinal obstruction and a palpable lump. Symptoms of other organ (e.g. lungs, genital tract) involvement and general symptoms of TB may also be present. Microbiological diagnosis is difficult in abdominal TB; histology and radiology are the mainstay of diagnosis. In the western world, abdominal TB may mimic the more common Crohn’s disease; malignancy (carcinoma and lymphoma) is also an important differential diagnosis. Most patients with abdominal TB can be treated with antitubercular therapy alone but some may require surgery, mainly for complications such as obstruction and perforation, and sometimes for confirmation of diagnosis. Surgical procedures in abdominal TB are conservative.