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Volume 43, Number 5, October 2010

Abdominal Tuberculosis in Adult: 10-Year Experience in a Teaching Hospital in Central Taiwan


Chia-Huei Chou, Mao-Wang Ho, Cheng-Mao Ho, Po-Chang Lin, Chin-Yun Weng, Tsung-Chia Chen, Chih-Yu Chi, Jen-Hsian Wang


Received: April 12, 2009    Revised: July 20, 2009    Accepted: August 20, 2009   

 

Corresponding author:

Chih-Yu Chi, Section of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Road, North District, Taichung City 40447, Taiwan.
E-mail: c3716@ms32.hinet.net



 

Background and purpose: 

Tuberculosis (TB) is an important communicable disease worldwide. The clinical presentation of abdominal TB often mimics various gastrointestinal disorders and may delay accurate diagnosis. In this study, we conducted a 10-year retrospective study to investigate the clinical manifestations, treatment responses and outcomes of abdominal TB



 

Methods:

This retrospective study recruited patients presenting between January 1998 and December
2007; all patients ≥ 18 years of age with a diagnosis of abdominal TB were enrolled. Patient charts were
thoroughly reviewed and clinical specimens were processed in the laboratory using the BBL MycoPrep
System and BACTEC MGIT 960 Mycobacterial Detection System. Mycobacterium tuberculosis complex was confirmed by acid fast stain and the BD ProbeTec ET System.



 

Results:

During the study period, 34 patients were diagnosed with abdominal TB. The mean age was 55 ± 18 years. Fourteen patients (41%) had no risk factors; however, 20 patients (59%) had at least one risk factor. Abdominal pain (94.1%), abdominal fullness (91.2%), anorexia (88.2%) and ascites (76.5%) were the
most common presenting symptoms. The peritoneum (88%) was the most commonly involved site.
Patients with risk factors such as liver cirrhosis, end-stage renal disease and diabetes mellitus had a higher
positive rate of acid-fast stain and mycobacterial culture from abdominal specimens (p = 0.02 and 0.05,
respectively). The crude mortality rate was 9% and the attributed mortality rate was 3%. 



 

Conclusion:

In an endemic area like Taiwan, regardless of whether a patient has risk factors for TB, abdominal TB should be seriously considered as a differential diagnosis when a patient presents with gastrointestinal symptoms and unexplained ascites.



 

Key words:

abdomen, granuloma, peritoneum, Taiwan, tuberculosis