Abdominal tuberculosis: analysis of clinical features and outcome of adult patients in southern Taiwan.
BACKGROUND
Abdominal tuberculosis remains a serious health threat. This retrospective report aimed to analyze patients after the development of the tuberculosis control program by the Center of Disease Control (Taiwan) in January 2000. The study was conducted at the Chang Gung Memorial Hospital-Kaohsiung, Taiwan.


METHODS
Between January 2000 and December 2006, we evaluated 14 adult patients with abdominal tuberculosis by reviewing their clinical information, therapeutic methods and outcomes. Diagnosis of abdominal tuberculosis was made based on clinical features of abdominal infection with microbiological results from culture, acid-fast bacilli stain and polymerase chain reaction for Mycobacterium tuberculosis and/or histopathological confirmation from biopsy and ascites.


RESULTS
Tuberculous peritonitis and intestinal tuberculosis were the most common type of infections followed by hepatic tuberculosis, and intra-abdominal tuberculoma. 35.7% of these patients had the coexistence of extra-abdominal infection. The most common clinical symptoms and signs were abdominal pain, abdominal distension, ascites and body weight loss. Fever was found in 35.7% of patients and peritoneal signs were noted in 7.1%. Immunocompromised states and old age are relevant to adult abdominal tuberculosis. Overall, patients were diagnosed by bacteriology (35.7%), biopsy materials from laparotomy (42.8%), liver biopsy (14.3%), and biopsy materials from colonoscopy (7.2%). Patients were cured after taking antituberculous drugs for at least 6 months without relapse during regular follow-up for at least 2 years. However, three patients died of sepsis and decompensated liver cirrhosis during treatment.


CONCLUSIONS
Extra vigilance in dealing with patients who present with unexplained abdominal conditions is the key to the diagnosis of abdominal tuberculosis. Early diagnosis, early antituberculous therapy and surgical treatment of the associated complications are essential for the survival of the patient.
Division of Hepato-gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Ming-Luen
ML
Hu
Chen-Hsiang
CH
Lee
Chung-Mou
CM
Kuo
Chao-Cheng
CC
Huang
Wei-Chen
WC
Tai
Kuo-Chin
KC
Chang
Chuan-Mo
CM
Lee
Seng-Kee
SK
Chuah
D000005:Abdomen / Q000382:microbiology; D000328:Adult; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D013624:Taiwan; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000188:drug therapy; D014386:Tuberculosis, Hepatic / Q000175:diagnosis* / Q000188:drug therapy