Surgical Management of Abdominal Tuberculosis

Imran Hassan, Emmanouil S. Brilakis, Rodney L. Thompson, Florencia G. Que

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Recent reports suggest an increased incidence of abdominal tuberculosis in the United States, particularly in high-risk groups. The aim of this study was to review the spectrum of abdominal tuberculosis and its surgical management at a tertiary referral center in the United States. The medical records of patients treated for abdominal tuberculosis at our institution between January 1992 and June 2001 were retrospectively reviewed. Eighteen patients were diagnosed with abdominal tuberculosis by microbiologic and/or histologic examination. The 10 men and eight women had a mean duration of symptoms of 4 months (range 1 to 24 months). Five were born in the United States, and 13 were foreign born (7 Asians and 6 Africans). The United States-born patients with abdominal tuberculosis, as compared to the foreign-born patients, were older (mean age 74 years vs. 35 years), more likely to have chronic medical illnesses (80% vs. 7%), and had concomitant pulmonary tuberculosis (60% vs. 0%). Computed tomography was the most frequent imaging modality (88%); findings suggestive of abdominal tuberculosis were mesenteric/omental stranding (50%), ascites (37%), and retroperitoneal lymphadenopathy (31%). Seventeen of the 18 patients required operative intervention, and one patient underwent CT-guided drainage of a psoas abscess. Laparoscopy was useful for diagnosis in eight patients; laparotomy was performed for complications of abdominal tuberculosis in six patients and to obtain a tissue diagnosis in three patients. Abdominal tuberculosis continues to represent a diagnostic challenge to clinicians. Among native-born white Americans, abdominal tuberculosis is primarily a disseminated disease of elderly, debilitated patients with chronic illnesses. Among foreign-born individuals, abdominal tuberculosis occurs in young, immunocompetent patients from endemic areas. Characteristic CT findings should be evaluated for abdominal tuberculosis in the appropriate clinical setting. Laparoscopy is an effective modality for diagnosis of peritoneal tuberculosis.

Original languageEnglish (US)
Pages (from-to)862-867
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume6
Issue number6
DOIs
StatePublished - 2002

Fingerprint

Tuberculosis
Laparoscopy
Chronic Disease
Tuberculous Peritonitis
Psoas Abscess
Pulmonary Tuberculosis
Population Groups
Ascites
Tertiary Care Centers
Laparotomy
Medical Records
Drainage
Tomography
Incidence

Keywords

  • Abdominal tuberculosis
  • Ct scans
  • Laparoscopy
  • Management
  • United states

ASJC Scopus subject areas

  • Surgery

Cite this

Surgical Management of Abdominal Tuberculosis. / Hassan, Imran; Brilakis, Emmanouil S.; Thompson, Rodney L.; Que, Florencia G.

In: Journal of Gastrointestinal Surgery, Vol. 6, No. 6, 2002, p. 862-867.

Research output: Contribution to journalArticle

Hassan, Imran ; Brilakis, Emmanouil S. ; Thompson, Rodney L. ; Que, Florencia G. / Surgical Management of Abdominal Tuberculosis. In: Journal of Gastrointestinal Surgery. 2002 ; Vol. 6, No. 6. pp. 862-867.
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