• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of postmedjPostgraduate Medical JournalCurrent TOCInstructions for authors
Postgrad Med J. Aug 1998; 74(874): 459–467.
PMCID: PMC2360888

Abdominal tuberculosis.

Abstract

Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cook GC. Tuberculosis--certainly not a disease of the past! Q J Med. 1985 Sep;56(221):519–521. [PubMed]
  • al Karawi MA, Mohamed AE, Yasawy MI, Graham DY, Shariq S, Ahmed AM, al Jumah A, Ghandour Z. Protean manifestation of gastrointestinal tuberculosis: report on 130 patients. J Clin Gastroenterol. 1995 Apr;20(3):225–232. [PubMed]
  • Fica A, Belletti J, Cruzat C, Rojas D, Montalva M. Tuberculosis intestinal: análisis de casos clínicos y autopsias. Rev Med Chil. 1991 Oct;119(10):1153–1159. [PubMed]
  • Hibbs RG, Kamal M, Farid Z. Abdominal tuberculosis in Cairo, Egypt. Trans R Soc Trop Med Hyg. 1994 May-Jun;88(3):317–318. [PubMed]
  • Das P, Shukla HS. Clinical diagnosis of abdominal tuberculosis. Br J Surg. 1976 Dec;63(12):941–946. [PubMed]
  • Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol. 1977 Apr;67(4):324–337. [PubMed]
  • Prakash A. Ulcero-constrictive tuberculosis of the bowel. Int Surg. 1978 Jul-Aug;63(5):23–29. [PubMed]
  • Tandon RK, Sarin SK, Bose SL, Berry M, Tandon BN. A clinico-radiological reappraisal of intestinal tuberculosis--changing profile? Gastroenterol Jpn. 1986 Feb;21(1):17–22. [PubMed]
  • Singh V, Jain AK, Agrawal AK, Gupta S, Khanna S, Khanna AK, Gupta JP. Clinicopathological profile of abdominal tuberculosis. Br J Clin Pract. 1995 Jan-Feb;49(1):22–24. [PubMed]
  • Al-Bahrani ZR, Al-Saleem T. Intestinal tuberculosis in Iraq: a study of 50 cases. Int Surg. 1982 Oct-Dec;67(4 Suppl):483–485. [PubMed]
  • al-Hadeedi S, Walia HS, al-Sayer HM. Abdominal tuberculosis. Can J Surg. 1990 Jun;33(3):233–237. [PubMed]
  • Lewis EA, Kolawole TM. Tuberculous ileo-colitis in Ibadan: a clinicoradiological review. Gut. 1972 Aug;13(8):646–653. [PMC free article] [PubMed]
  • al-Quorain AA, Facharzt, Satti MB, al-Freihi HM, al-Gindan YM, al-Awad N. Abdominal tuberculosis in Saudi Arabia: a clinicopathological study of 65 cases. Am J Gastroenterol. 1993 Jan;88(1):75–79. [PubMed]
  • El Masri SH, Boulos P, Malick MO. Abdominal tuberculosis in Sudanese patients. East Afr Med J. 1977 Jun;54(6):319–326. [PubMed]
  • Innes JA. Non-respiratory tuberculosis. J R Coll Physicians Lond. 1981 Oct;15(4):227–231. [PubMed]
  • Klimach OE, Ormerod LP. Gastrointestinal tuberculosis: a retrospective review of 109 cases in a district general hospital. Q J Med. 1985 Sep;56(221):569–578. [PubMed]
  • Addison NV. Abdominal tuberculosis--a disease revived. Ann R Coll Surg Engl. 1983 Mar;65(2):105–111. [PMC free article] [PubMed]
  • Jayanthi V, Probert CS, Sher KS, Wicks AC, Mayberry JF. The renaissance of abdominal tuberculosis. Dig Dis. 1993;11(1):36–44. [PubMed]
  • Palmer KR, Patil DH, Basran GS, Riordan JF, Silk DB. Abdominal tuberculosis in urban Britain--a common disease. Gut. 1985 Dec;26(12):1296–1305. [PMC free article] [PubMed]
  • Probert CS, Jayanthi V, Wicks AC, Carr-Locke DL, Garner P, Mayberry JF. Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut. 1992 Aug;33(8):1085–1088. [PMC free article] [PubMed]
  • Mandal BK, Schofield PF. Abdominal tuberculosis in Britain. Practitioner. 1976 Jun;216(1296):683–689. [PubMed]
  • Findlay JM, Addison NV, Stevenson DK, Mirza ZA. Tuberculosis of the gastrointestinal tract in Bradford, 1967-77. J R Soc Med. 1979 Aug;72(8):587–590. [PMC free article] [PubMed]
  • Lambrianides AL, Ackroyd N, Shorey BA. Abdominal tuberculosis. Br J Surg. 1980 Dec;67(12):887–889. [PubMed]
  • Sharp JF, Goldman M. Abdominal tuberculosis in East Birmingham--a 16 year study. Postgrad Med J. 1987 Jul;63(741):539–542. [PMC free article] [PubMed]
  • Dineeen P, Homan WP, Grafe WR. Tuberculous peritonitis: 43 years' expereince in diagnosis and treatment. Ann Surg. 1976 Dec;184(6):717–722. [PMC free article] [PubMed]
  • Homan WP, Grafe WR, Dineen P. A 44-year experience with tuberculous enterocolitis. World J Surg. 1977 Mar;2(1):245–250. [PubMed]
  • Sherman S, Rohwedder JJ, Ravikrishnan KP, Weg JG. Tuberculous enteritis and peritonitis. Report of 36 general hospital cases. Arch Intern Med. 1980 Apr;140(4):506–508. [PubMed]
  • McGee GS, Williams LF, Potts J, Barnwell S, Sawyers JL. Gastrointestinal tuberculosis: resurgence of an old pathogen. Am Surg. 1989 Jan;55(1):16–20. [PubMed]
  • Guth AA, Kim U. The reappearance of abdominal tuberculosis. Surg Gynecol Obstet. 1991 Jun;172(6):432–436. [PubMed]
  • Ko CY, Schmit PJ, Petrie B, Thompson JE. Abdominal tuberculosis: the surgical perspective. Am Surg. 1996 Oct;62(10):865–868. [PubMed]
  • Rosengart TK, Coppa GF. Abdominal mycobacterial infections in immunocompromised patients. Am J Surg. 1990 Jan;159(1):125–131. [PubMed]
  • Goldman KP. AIDS and tuberculosis. Tubercle. 1988 Mar;69(1):71–72. [PubMed]
  • Fee MJ, Oo MM, Gabayan AE, Radin DR, Barnes PF. Abdominal tuberculosis in patients infected with the human immunodeficiency virus. Clin Infect Dis. 1995 Apr;20(4):938–944. [PubMed]
  • Watters DA. Surgery for tuberculosis before and after human immunodeficiency virus infection: a tropical perspective. Br J Surg. 1997 Jan;84(1):8–14. [PubMed]
  • Iseman MD. Treatment of multidrug-resistant tuberculosis. N Engl J Med. 1993 Sep 9;329(11):784–791. [PubMed]
  • Shah P, Ramakantan R. Role of vasculitis in the natural history of abdominal tuberculosis--evaluation by mesenteric angiography. Indian J Gastroenterol. 1991 Oct;10(4):127–130. [PubMed]
  • Shah S, Thomas V, Mathan M, Chacko A, Chandy G, Ramakrishna BS, Rolston DD. Colonoscopic study of 50 patients with colonic tuberculosis. Gut. 1992 Mar;33(3):347–351. [PMC free article] [PubMed]
  • Singh V, Kumar P, Kamal J, Prakash V, Vaiphei K, Singh K. Clinicocolonoscopic profile of colonic tuberculosis. Am J Gastroenterol. 1996 Mar;91(3):565–568. [PubMed]
  • Chen WS, Leu SY, Hsu H, Lin JK, Lin TC. Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis. Dis Colon Rectum. 1992 Feb;35(2):189–192. [PubMed]
  • Essop AR, Posen JA, Hodkinson JH, Segal I. Tuberculosis hepatitis: a clinical review of 96 cases. Q J Med. 1984 Autumn;53(212):465–477. [PubMed]
  • Katariya RN, Sood S, Rao PG, Rao PL. Stricture-plasty for tubercular strictures of the gastro-intestinal tract. Br J Surg. 1977 Jul;64(7):496–498. [PubMed]
  • Pujari BD. Modified surgical procedures in intestinal tuberculosis. Br J Surg. 1979 Mar;66(3):180–181. [PubMed]
  • Sharma AK, Agarwal LD, Sharma CS, Sarin YK. Abdominal tuberculosis in children: experience over a decade. Indian Pediatr. 1993 Sep;30(9):1149–1153. [PubMed]
  • Tandon RK, Bansal R, Kapur BM, Shriniwas A study of malabsorption in intestinal tuberculosis: stagnant loop syndrome. Am J Clin Nutr. 1980 Feb;33(2):244–250. [PubMed]
  • Monkemuller KE, Lewis JB., Jr Massive rectal bleeding from colonic tuberculosis. Am J Gastroenterol. 1996 Jul;91(7):1439–1441. [PubMed]
  • Puri AS, Vij JC, Chaudhary A, Kumar N, Sachdev A, Malhotra V, Malik VK, Broor SL. Diagnosis and outcome of isolated rectal tuberculosis. Dis Colon Rectum. 1996 Oct;39(10):1126–1129. [PubMed]
  • Alyoune M, Nadir S, Merzouk M, Mounadif A, Biadillah MC, Jamil D, Alaoui R, Cherkaoui A. Fistules anales tuberculeuses. A propos de treize cas. Ann Gastroenterol Hepatol (Paris) 1994 Jan-Feb;30(1):9–11. [PubMed]
  • Di Placido R, Pietroletti R, Leardi S, Simi M. Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction. Am J Gastroenterol. 1996 Apr;91(4):807–808. [PubMed]
  • Wells AD, Northover JM, Howard ER. Abdominal tuberculosis: still a problem today. J R Soc Med. 1986 Mar;79(3):149–153. [PMC free article] [PubMed]
  • Ali W, Sikora SS, Banerjee D, Kapoor VK, Saraswat VA, Saxena R, Kaushik SP. Gastroduodenal tuberculosis. Aust N Z J Surg. 1993 Jun;63(6):466–467. [PubMed]
  • Monge E, Lozano R, Salazar S. Esophageal tuberculosis. Am J Gastroenterol. 1992 Jan;87(1):156–156. [PubMed]
  • Hashimoto M, Koyama H, Noie T, Shibayama K, Kitamura N. Abdominal tuberculoma mimicking a pancreatic neoplasm: report of a case. Surg Today. 1995;25(4):365–368. [PubMed]
  • Mokoena T, Bairagi N. Acute tuberculous pancreatitis associated with HIV infection. Trop Doct. 1994 Oct;24(4):172–173. [PubMed]
  • Sözbilen M, Erhan Y, Koyuncu A. Tuberculosis of the pancreas. Br J Surg. 1992 Aug;79(8):802–802. [PubMed]
  • Bastani B, Shariatzadeh MR, Dehdashti F. Tuberculous peritonitis--report of 30 cases and review of the literature. Q J Med. 1985 Sep;56(221):549–557. [PubMed]
  • Diab S, Abu Nema T, Abu Zidan F. Portal hypertension complicating abdominal tuberculosis. Case report. Acta Chir Scand. 1990 Jun-Jul;156(6-7):495–497. [PubMed]
  • Murphy TF, Gray GF. Biliary tract obstruction due to tuberculous adenitis. Am J Med. 1980 Mar;68(3):452–454. [PubMed]
  • Eggleston FC, Deodhar MC, Kumar A. Tuberculous perforation of the bowel--results in 21 cases. Trop Gastroenterol. 1983 Jul-Sep;4(3):164–167. [PubMed]
  • Kakar A, Aranya RC, Nair SK. Acute perforation of small intestine due to tuberculosis. Aust N Z J Surg. 1983 Aug;53(4):381–383. [PubMed]
  • Dhar A, Bagga D, Taneja SB. Perforated tubercular enteritis of childhood: a ten year study. Indian J Pediatr. 1990 Sep-Oct;57(5):713–716. [PubMed]
  • Yachha SK, Misra S, Malik AK, Nagi B, Mehta S. Spectrum of malabsorption syndrome in north Indian children. Indian J Gastroenterol. 1993 Oct;12(4):120–125. [PubMed]
  • Nistal de Paz F, Herrero Fernández B, Pérez Simón R, Fernández Pérez E, Nistal de Paz C, Ortoll Battle P, Muñoz Rodríguez M. Pelvic-peritoneal tuberculosis simulating ovarian carcinoma: report of three cases with elevation of the CA 125. Am J Gastroenterol. 1996 Aug;91(8):1660–1661. [PubMed]
  • Underwood MJ, Thompson MM, Sayers RD, Hall AW. Presentation of abdominal tuberculosis to general surgeons. Br J Surg. 1992 Oct;79(10):1077–1079. [PubMed]
  • Walia HS, Khafagy AR, al-Sayer HM, Walia HK, al-Nakib B, Sivanandan R. Unusual presentations of abdominal tuberculosis. Can J Surg. 1994 Aug;37(4):300–306. [PubMed]
  • Kapoor VK. Koch's or Crohn's? Int J Clin Pract. 1997 Jun;51(4):246–247. [PubMed]
  • Misra A, Khanduri A, Jain M, Gupta RK, Choudhuri G. Colonic tuberculosis presenting as diffuse pancolitis. Indian J Gastroenterol. 1996 Jul;15(3):105–105. [PubMed]
  • Aguado JM, Pons F, Casafont F, San Miguel G, Valle R. Tuberculous peritonitis: a study comparing cirrhotic and noncirrhotic patients. J Clin Gastroenterol. 1990 Oct;12(5):550–554. [PubMed]
  • Chawla TC, Sharma A, Kiran U, Bhargava DK, Tandon BN. Serodiagnosis of intestinal tuberculosis by enzyme immunoassay and soluble antigen fluorescent antibody tests using a saline extracted antigen. Tubercle. 1986 Mar;67(1):55–60. [PubMed]
  • Bhargava DK, Dasarathy S, Shriniwas MD, Kushwaha AK, Duphare H, Kapur BM. Evaluation of enzyme-linked immunosorbent assay using mycobacterial saline-extracted antigen for the serodiagnosis of abdominal tuberculosis. Am J Gastroenterol. 1992 Jan;87(1):105–108. [PubMed]
  • Kashima K, Oka S, Tabata A, Yasuda K, Kitano A, Kobayashi K, Yano I. Detection of anti-cord factor antibodies in intestinal tuberculosis for its differential diagnosis from Crohn's disease and ulcerative colitis. Dig Dis Sci. 1995 Dec;40(12):2630–2634. [PubMed]
  • Lundstedt C, Nyman R, Brismar J, Hugosson C, Kagevi I. Imaging of tuberculosis. II. Abdominal manifestations in 112 patients. Acta Radiol. 1996 Jul;37(4):489–495. [PubMed]
  • Kapoor VK, Chattopadhyay TK, Sharma LK. Radiology of abdominal tuberculosis. Australas Radiol. 1988 Aug;32(3):365–367. [PubMed]
  • Singh MM, Bhargava AN, Jain KP. Tuberculous peritonitis. An evaluation of pathogenetic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med. 1969 Nov 13;281(20):1091–1094. [PubMed]
  • Sheikh M, Abu-Zidan F, al-Hilaly M, Behbehani A. Abdominal tuberculosis: comparison of sonography and computed tomography. J Clin Ultrasound. 1995 Sep;23(7):413–417. [PubMed]
  • Kedar RP, Shah PP, Shivde RS, Malde HM. Sonographic findings in gastrointestinal and peritoneal tuberculosis. Clin Radiol. 1994 Jan;49(1):24–29. [PubMed]
  • Liu KW, Chan YL, Tseng R, Oppenheimer SJ. Childhood abdominal tuberculosis. The role of echo-guided fine-needle aspiration in its management. Surg Endosc. 1994 Apr;8(4):326–328. [PubMed]
  • Bankier AA, Fleischmann D, Wiesmayr MN, Putz D, Kontrus M, Hübsch P, Herold CJ. Update: abdominal tuberculosis--unusual findings on CT. Clin Radiol. 1995 Apr;50(4):223–228. [PubMed]
  • Lisehora GB, Peters CC, Lee YT, Barcia PJ. Tuberculous peritonitis--do not miss it. Dis Colon Rectum. 1996 Apr;39(4):394–399. [PubMed]
  • Ha HK, Jung JI, Lee MS, Choi BG, Lee MG, Kim YH, Kim PN, Auh YH. CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR Am J Roentgenol. 1996 Sep;167(3):743–748. [PubMed]
  • Rodríguez E, Pombo F. Peritoneal tuberculosis versus peritoneal carcinomatosis: distinction based on CT findings. J Comput Assist Tomogr. 1996 Mar-Apr;20(2):269–272. [PubMed]
  • Anand BS, Schneider FE, El-Zaatari FA, Shawar RM, Clarridge JE, Graham DY. Diagnosis of intestinal tuberculosis by polymerase chain reaction on endoscopic biopsy specimens. Am J Gastroenterol. 1994 Dec;89(12):2248–2249. [PubMed]
  • Wilkins EG. Tuberculosis peritonitis: diagnostic value of the ascitic/blood glucose ratio. Tubercle. 1984 Mar;65(1):47–52. [PubMed]
  • Dwivedi M, Misra SP, Misra V, Kumar R. Value of adenosine deaminase estimation in the diagnosis of tuberculous ascites. Am J Gastroenterol. 1990 Sep;85(9):1123–1125. [PubMed]
  • Evine H. Needle biopsy diagnosis of tuberculous peritonitis. Am Rev Respir Dis. 1968 May;97(5):889–894. [PubMed]
  • Bhargava DK, Shriniwas, Chopra P, Nijhawan S, Dasarathy S, Kushwaha AK. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol. 1992 Jan;87(1):109–112. [PubMed]
  • Shukla HS, Bhatia S, Naitrani YP, Das P, Gupta SC. Peritoneal biopsy for diagnosis of abdominal tuberculosis. Postgrad Med J. 1982 Apr;58(678):226–228. [PMC free article] [PubMed]
  • Tandon HD, Prakash A. Pathology of intestinal tuberculosis and its distinction from Crohn's disease. Gut. 1972 Apr;13(4):260–269. [PMC free article] [PubMed]
  • Anand BS, Nanda R, Sachdev GK. Response of tuberculous stricture to antituberculous treatment. Gut. 1988 Jan;29(1):62–69. [PMC free article] [PubMed]
  • Schofield PF. Abdominal tuberculosis. Gut. 1985 Dec;26(12):1275–1278. [PMC free article] [PubMed]
  • Jayaswal R, Jena PK, Gopinathan VP, Chauhan MS. Recurrent acute tuberculous perforations of small intestine associated with miliary tuberculosis of lung. J Assoc Physicians India. 1986 Nov;34(11):817–818. [PubMed]
  • Cooke NJ. Treatment of tuberculosis. Br Med J (Clin Res Ed) 1985 Aug 24;291(6494):497–498. [PMC free article] [PubMed]
  • Haddad FS, Ghossain A, Sawaya E, Nelson AR. Abdominal tuberculosis. Dis Colon Rectum. 1987 Sep;30(9):724–735. [PubMed]
  • Kapoor VK, Sharma LK. Abdominal tuberculosis. Br J Surg. 1988 Jan;75(1):2–3. [PubMed]
  • Vanderpool DM, O'Leary JP. Primary tuberculous enteritis. Surg Gynecol Obstet. 1988 Aug;167(2):167–173. [PubMed]
  • Lingenfelser T, Zak J, Marks IN, Steyn E, Halkett J, Price SK. Abdominal tuberculosis: still a potentially lethal disease. Am J Gastroenterol. 1993 May;88(5):744–750. [PubMed]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Group

Formats: