Abdominal tuberculosis - experience of a University hospital in Oman

Objective: To determine the clinical presentation and assess the usefulness of various diagnostic modalities and outcome of treatment of abdominal tub erculosis (TB). Materials and methods: The files of patients admitted to Su ltan Qaboos University Hospital (SQUH) with a diagnosis of abdominal TB fro m January 91 to December 99 were studied retrospectively and data abstracte d. Results: Eighteen patients were diagnosed during this period, of which t en were males. The median age was 27 years (range 5-65). The common symptom s were fever, weight loss, anorexia, and abdominal pain. Abdominal signs we re less frequent and included hepatomegaly and ascites. Eight patients had co-existent immunocompromised disorders; two of these had active pulmonary TB. Diagnostic investigations included gastrointestinal contrast studies in two, ultrasound (US) guided fine needle aspiration cytology (FNAC) in nine , and laparoscopy and/or laparotomy in seven. All patients underwent antitu berculous therapy for 9-12 months, in addition to the treatment of associat ed disorders. The response to antituberculous therapy was good except in on e patient with HIV. Four patients died from associated primary disorders. C onclusions: The clinical presentation was non-specific and nearly half of t he patients had associated immunocompromised disorders; thus a high index o f clinical suspicion is required. US guided FNAC and selective laparoscopy were the most useful diagnostic modalities. Antituberculous therapy was eff ective. (C) 2001 Elsevier Science B.V. All rights reserved.