Clinical Study of Abdominal Tuberculosis in Children.

ABSTRACT

Background: Abdominal TB is well described in adults, but is relatively rare in children in the modern era. Abdominal involvement is uncommon in children, occurring with an incidence of approximately 10% under the age of 10 years. Due to multiple manifestations a high index of suspicion accompanied by the appropriate investigations help in diagnosis. The diagnosis of gastrointestinal tuberculosis is challenging as it presents with a variety of symptoms. A high index of suspicion is essential. Medical treatment is the mainstay of therapy. The role of surgery is principally in diagnosis and the management of complications. Methods: This hospital based observational study was conducted prospectively for two years in a tertiary care hospital. Data including presenting symptoms(distension of abdomen, pain abdomen, lump abdomen),Signs (Loculated ascites, perforation & peritonitis) history of Bacille Calmette- Guerin vaccination, lesion sites, laboratory data, image findings, diagnosis, tuberculin skin test, risk factors, treatment, and outcome were collected and analyzed. Results: The present study conducted over a period of two years in a tertiary care hospital, a total number of 15 cases were presented by M F 69 ratio. Preponderance (10 patients) was found in the age group of 10-15 years. Adenosine deaminase levels >32 IU/lt taken as significant. 6 cases presented as ascitic form of abdominal tuberculosis in this series and all cases had significant ADA levels. 8 cases were confirmed with histopathological examination. Conclusion: Abdominal Tuberculosis in children is uncommon and present with protean manifestations. Ascitic fluid adenosine deaminase level more than 32 IU/L has significant clinical correlation in ascitic form of abdominal tuberculosis. The commonest complication of gastrointestinal tuberculosis is intestinal obstruction. Diagnostic laparoscopy is useful in cases presented with chronic pain abdomen with nonspecific clinicoradiological findings mainly in peritoneal tuberculosis. Surgical intervention has tremendous role in treating the complications.