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Management of abdominal tuberculosis in a community-based hospital in a high-income developing country

Authors
  • Mousa, Hussam1
  • Abdel-Kader, Saleh1
  • Abu-Zidan, Fikri M.2
  • 1 Al-Ain Hospital, Al-Ain, UAE , Al-Ain (United Arab Emirates)
  • 2 UAE University, Al-Ain, UAE , Al-Ain (United Arab Emirates)
Type
Published Article
Journal
World Journal of Emergency Surgery
Publisher
Springer (Biomed Central Ltd.)
Publication Date
May 26, 2021
Volume
16
Issue
1
Identifiers
DOI: 10.1186/s13017-021-00370-3
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe delayed diagnosis and management of abdominal tuberculosis increases its mortality. We aimed to study the clinical presentation, management, and outcome of patients who had abdominal tuberculosis and were treated at Al-Ain Hospital, Al-Ain City, United Arab Emirates.MethodsAll patients who had abdominal tuberculosis and were treated at Al-Ain Hospital between January 2011 and December 2018 were studied. Data were collected retrospectively using a structured protocol including demography, clinical presentation, diagnostic methods, management, and outcome.ResultsTwenty-four patients having a median age of 30 years were studied with an incidence of 0.6/100,000 population. The most common symptoms were abdominal pain (95.8%) and malaise (79.2%). Fever was present only in nine patients (37.5%). Laboratory investigations, except for polymerase chain reaction immunoassay, were not helpful. Chest X-ray was abnormal in three patients (12.5%). Ultrasound and abdominal CT scan were non-specific. Thirteen patients needed surgical intervention for diagnosis or therapy. Diagnosis was confirmed by histopathology in 15 patients (62.5%), immunological assays in 7 patients (29.2%), microbiological culture in 1 patient (4%), and therapeutic trial in 1 patient (4%). The most common type of abdominal tuberculosis was gastrointestinal in 13 patients (54.2%) followed by free wet peritonitis in 5 patients (20.8%). All patients had quadruple anti-tuberculous therapy for a minimum of 6 months. The median hospital stay was 6.5 days. None of our patients died.ConclusionsDiagnosis of abdominal tuberculosis remains challenging despite advances in medical technology and diagnostic tools. The limited need for diagnostic therapy in our study supports the benefit of PCR assay. Surgery was mainly indicated as the last option to reach the diagnosis or to treat complications.

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