Singhal, A.; Gulati, A.; Frizell, R.; Manning, A.P.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA101
Academic Journal
Introduction: Bradford has a population of around 480 000, of which 18% originate from the Indian subcontinent (ISC). We describe our experience of abdominal tuberculosis (ATB) over a 10 year period. Methods: 59 cases of ATB were identified between 1992 to 2002 from the Tuberculosis Registry (TB), Bradford hospitals. 50 case records were available for retrospective review. Results: Mean age of the patients was 41 years (range 14-81) and 29 (58%) were females. 46 (92%) patients originated From ISC, 3 (6%) were Caucasians, and 1 patient Arabic. Fever (90%), abdominal pain (88%), and weight loss (82%) were the commonest presenting features. Ascites in 22 (44%) and abdominal mass in 11 (22%) were common findings. At presentation, 25 (50%) patients had haemoglobin < 11 gm/dl and 30 (60%) had albumen less than 32 g/I. History of contact with TB was available in 11 (22%) cases and 5 (10%) patients had past history of treated TB. Ileocaecal (lC) region in 20 (40%) patients and TB peritonitis in 16 (32%) cases were the commonest sites involved. Liver infiltration and colonic disease each, was seen in 6 (12%) cases and 8 (16%) patients had disseminated abdominal TB. Simultaneous pulmonary involvement was present in 27 (54%) patients. Diagnosis of TB was confirmed by isolating acid fast bacilli (AFB) or by demonstrating caseating granulomas on biopsy in 36 (72%) cases. AFB isolated in all the 29 (58%) cases was Mycobacterium hominis and were sensitive to all standard anti-tubercular drugs (ATT) except in 1 case resistant to INH. All patients had ATT, which was well tolerated in 84%. Duration of ATTvaried from 6-18 months. Conclusion: Abdominal TB is a common problem in a multicultural community in the United Kingdom with a variety of presentations. High index of: suspicion is required for early diagnosis. Multi drug resistant ATB has not been a significant problem in this series.


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