title: Tuberculosis in the belly: a review of forty-six cases involving the gastrointestinal tract and peritoneum.
abstract: BACKGROUND
  Abdominal tuberculosis has varied presentation and can be confused with other conditions.
  
  
  METHODS
  We report our experience with 46 patients. Charts of patients managed during 1984-97 were reviewed.
  
  
  RESULTS
  Fifty-two percent were women and mean age was 46 years. Presenting symptoms were as follows: fever 70%; abdominal pain 70%; weight loss 68%; abdominal swelling 67%; change in bowel habit 39%; anorexia 30%; and sweating 30%. Common physical signs were as follows: fever 73%; ascites 61%; abdominal mass 13%; and doughy abdomen 9%. Thirty percent of patients either gave past history of TB or presented with active TB of other sites. TB skin test was positive in only 27% of patients. CT scans of abdomen were abnormal in 80%, showing ascites, peritoneal lesions or enlarged nodes. Ascitic fluid was diagnostic for TB on smear/culture in 33%. Peritoneal biopsy was performed by laparoscopy or laparotomy in 61%. It was positive for ganulomas in 97% and for smear/culture in 68%. Forty-two patients recovered after receiving anti-TB therapy for 9-12 months. Four patients died. One died within 1 month of initiation of therapy due to extensive TB, and death in the other 3 was due to unrelated causes.
  
  
  CONCLUSIONS
  Abdominal TB should be suspected in patients with fever, abdominal pain and ascites. This condition carries good prognosis if promptly diagnosed and treated.
authors.affiliation: Dept. of Pediatrics, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
authors.forename: M A
authors.initials: MA
authors.lastname: Muneef
authors.forename: Z
authors.initials: Z
authors.lastname: Memish
authors.forename: S A
authors.initials: SA
authors.lastname: Mahmoud
authors.forename: S A
authors.initials: SA
authors.lastname: Sadoon
authors.forename: R
authors.initials: R
authors.lastname: Bannatyne
authors.forename: Y
authors.initials: Y
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D012529:Saudi Arabia; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents