Abdominal tuberculosis: Is there a role for surgery?

Abstract

It is important that surgeons are familiar with the various manifestations of tuberculosis (TB). Although TB has been declining in incidence in the developed world, it remains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.

Keywords: Anti-tuberculous therapy; Intestinal; Peritoneal; Surgery; Tuberculosis.

Figure 1

Intestinal tuberculosis (ileocaecal) (with permission from Chumber et al[51], 2001).

Figure 2

Histopathology (H/E stain): Showing multiple mucosal and submucosal epitheloid cell granulomas with Langhan’s giant cells in a case of colonic tuberculosis (with permission from Tandon et al[35], 1972).

Figure 3

Peritoneal tuberculosis (with permission from Bolognesi et al[43], 2013).