Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 16;3(3):201-205.
doi: 10.1002/jgh3.12136. eCollection 2019 Jun.

A real-world experience with 6 months of antitubercular therapy in abdominal tuberculosis

Harshal S Mandavdhare  1 , Harjeet Singh  1 , Usha Dutta  1 , Vishal Sharma  1
Affiliations

A real-world experience with 6 months of antitubercular therapy in abdominal tuberculosis

Harshal S Mandavdhare et al. JGH Open. .

Abstract

Background and aim: Abdominal tuberculosis is an important form of extrapulmonary tuberculosis. Evidence from clinical trials suggests that 6 months of antitubercular therapy (ATT) is sufficient for abdominal tuberculosis.

Methods: We report real-world experience with 6 months of ATT based on a retrospective analysis of patients with abdominal tuberculosis seen at a large tertiary care hospital in India.

Results: Of 101 patients, 93 with complete records were included. The mean age was 35.90 ± 14.06 years, and 53 were males (56.98%). A total of 42 patients (45.16%) had intestinal involvement, 24 (25.08%) had peritoneal, 22 (23.65%) had combined involvement, and 5 patients (5.37%) had isolated lymph nodal involvement. Six patients received prolonged ATT. Six patients developed ATT-induced hepatitis. Of 64 patients with intestinal involvement, 45 had stricturing disease (70.3%), of whom 7 (15.5%) required surgery due to refractory symptoms. Overall, there was one death, and eight patients (including one with massive gastrointestinal bleeding) needed surgery.

Conclusion: Six months of ATT is associated with objective clinical response in most of the patients of abdominal tuberculosis.

Keywords: hepatitis; intestinal tuberculosis; peritoneal tuberculosis; surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Computed tomography showing thickened ascending colon and caecum.
Figure 2
Figure 2
Colonoscopic image showing circumferential ulceration with narrowing.
Figure 3
Figure 3
Chart showing patterns of involvement in patients with abdominal tuberculosis. †AFB positivity from sputum in five and intestinal tissue in four. ‡One pulmonary and one from peritoneal FNA. §All pulmonary. ADA, adenosine deaminase; AFB, acid fast bacilli; RTT, response to therapy.
Figure 4
Figure 4
Outcomes in patients with abdominal tuberculosis. ATT, antitubercular therapy; CNS, central nervous system; ITB, intestinal tuberculosis; TB, tuberculosis.
See this image and copyright information in PMC

References

    1. Sharma SK, Ryan H, Khaparde S et al INDEX‐TB guidelines: guidelines on management of extrapulmonary tuberculosis of India. Indian J. Med. Res. 2017; 145: 448–63. - PMC - PubMed
    1. Limsrivilai J, Shreiner AB, Pongpaibul A et al Meta‐analytic bayesian model for differentiating intestinal tuberculosis from Crohn's disease. Am. J. Gastroenterol. 2017; 112: 415–27. - PMC - PubMed
    1. Sharma V, Bhatia A, Malik S, Singh N, Rana SS. Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis. Ther. Adv. Infect. Dis. 2017; 4: 3–9. - PMC - PubMed
    1. Makharia GK, Ghoshal UC, Ramakrishna BS et al Intermittent directly observed therapy for abdominal tuberculosis: a multicenter randomized controlled trial comparing 6 months versus 9 months of therapy. Clin. Infect. Dis. 2015; 61: 750–7. - PubMed
    1. Jullien S, Jain S, Ryan H, Ahuja V. Six‐month therapy for abdominal tuberculosis. Cochrane Database Syst. Rev. 2016; 11: CD012163. - PMC - PubMed

LinkOut - more resources