Abdominal TB

1. Abdominal Tuberculosis

2. 70% of patients with
advanced pulmonary disease acquired
gastrointestinal tuberculosis
from swallowing infectious secretions

3. Main types
• GI TB
• Mesenteric lymph
node TB
• Retroperitoneal
cavity TB
• Peritoneal TB

4. Symptoms
• Abdominal pain
• Nausea
• Loss of appetite
• Low grade fever
• GI dysfunction
• Ascites
• Diarrhea
• Constipation

5. Esophagus
• From adjacent casous node

6. Stomach
• Ulcerative, gastric outlet obstruction
• Duodenal disease causes same symptoms

7. Small Bowel
• Perforation, obstruction, fistula, hemorrhage,
malabsorption

8. Ileocecal Area
• Typical site of TB
• Pain
• Anorexia
• Diarrhea
• Palpable mass

9. Tuberculous peritonitis results either from
spread of adjacent tuberculous disease such as
an abdominal lymph node, intestinal focus, or
fallopian tube, or during miliary tuberculosis.

10. Symptoms
• Ascites
• Weight loss
• Abdominal pain
• Fever
Peritoneal fluid is exudative, with high amount of lymphocytes

11. Diagnosis
• Anamnesis
• Biochemistry test
• Endoscopy
• Biopsy
• Mantoux test
• Chest X-ray
• Abdominal X-ray
• Ultrasound
• Ascitic fluid examination
Anemia, raised ESR,
hypoalbumenemia,
leucopenia with relative
lymphocytosis, normal
serum transminase level

12. Differential Diagnosis
• Malabsorption
- Coeliac disease
- Lymphoma
- Immunoproliferative small intestinal disease
• Mass
- Appendicular mass
- Crohn’s disease
- Carcinoma
- Lymphoma
• Ascites
- Cardiac disease
- Renal disease
- Hepatic disease