Abdominal tuberculosis, a diagnostic dilemma: report of a series of cases

INTRODUCTION Abdominal tuberculosis is one of the most common non-pulmonary tuberculosis infection sites, and it relates to immunosuppression. The nonspecific features of this form of tuberculosis make an accurate diagnosis difficult. The aim of this study is to report seven (7) patients diagnosed with abdominal tuberculosis requiring surgery at the Clinical Hospital of Pontificia Universidad Catclica de Chile. METHODS A descriptive analysis of seven cases of abdominal tuberculosis treated in our center between August 2001 and June 2013 was performed to characterize its clinical presentation and diagnostic elements. RESULTS Four men and three women (29-68 years old) were diagnosed and operated on for abdominal tuberculosis: three had the peritoneal form of tuberculosis, two had a lymph nodal form and two had the intestinal form. In three cases, abdominal tuberculosis was associated with immunosuppression (HIV and rheumatoid arthritis treatment) and six cases presented with wasting syndrome of at least one month duration. Three patients had an acute presentation with signs of intestinal obstruction. Diagnosis was made by surgical biopsy. Of the seven patients, who underwent surgery, three required bowel resection for intestinal obstruction. CONCLUSION Abdominal tuberculosis requires a high index of suspicion for an early diagnosis, especially in populations at risk.