Abdominal Tuberculosis

Abstract

Abdomen is involved in 11% of patients with extra-pulmonary tuberculosis; The most common site of involvement is the ileocaecal region, other locations of involvement, in order of descending frequency, are the ascending colon, jejunum, appendix, duodenum, stomach, oesophagus, sigmoid colon, and rectum. Apart from the basic work up, Investigations like CT scan, EUS, Capsule endoscopy, Balloon enteroscopy, Ascitic fluid ADA, TB-PCR, GeneXpert, Laproscopy are being increasingly used to diagnose tuberculosis.Therapy with standard antituberculous drugs is usually highly effective for intestinal TB. Six-months therapy is as effective as nine-months therapy. Multi-Drug Resistance (MDR) has been observed in 13% of MTB isolates. The development of Drug Induced Hepatotoxicity (DIH) during therapy for TB is the most common reason leading to interruption of therapy. There are various guidelines for the management of TB post DIH. Surgery is usually reserved for patients who have developed complications or obstruction not responding to medical management.