Objective: To review unusual presenting features and diagnostic diffic
ulties of abdominal tuberculosis in an endemic region. Design: Retrosp
ective clinical study from 1984 to 1989, illustrated by case reports.
Setting. A single hospital in Kuwait. Patients: Fifty patients with ab
dominal tuberculosis established by the standard histologic and bacter
iologic demonstration of acid-fast bacilli or tuberculous granulomas.
Main Outcome Measures: Site of disease and unusual features at present
ation. Results: Tubercular lesions are most commonly seen in the ileoc
ecal region. They are also common in the ileum but are less common in
the appendix and jejunum. Involvement of the ascending colon, rectum a
nd upper gastrointestinal tract is rare. Abdominal tuberculosis presen
ts in many ways depending on the degrees of ulceration, fibrous healin
g, infection and caseating abscess formation. Conclusions: Abdominal t
uberculosis should be considered in immigrants from regions where this
disease is endemic who present with abdominal signs and symptoms. Ima
ging studies, endoscopy and laparoscopy may preclude laparotomy for th
e diagnosis of abdominal tuberculosis. Antituberculosis chemotherapy i
s the mainstay of treatment.