Intra-Abdominal Tuberculosis

Intra-Abdominal Tuberculosis

Tuberculosis can involve any part of the gastrointestinal tract, genitourinary tract, peritoneum, mesentery, abdominal lymph nodes, and omentum. Tuberculosis reaches the sites by hematogenous spread or from direct extension from an adjacent foci of infection. The incidence of abdominal tuberculosis remains steady in developing nations and has risen in recent decades in developed countries in association with HIV infection and the use of immunosuppressive medications. The most common site of involvement of the gastrointestinal tract is the ileocecal region. Clinical presentation is vague and nonspecific. Imaging can be suggestive of tuberculous disease and can be helpful in demonstrating the extent of the disease and associated complications. CT is generally the most useful imaging modality. Ideally, a cluster of epidemiologic, clinical, bacteriologic, histologic, and radiologic evidence can clinch the diagnosis of tuberculosis. The pathognomonic feature of tuberculosis is caseation, a feature that is not constant. Definitive diagnosis requires demonstration of the mycobacteria by staining, culture or on histopathology of ascites or tissue samples.