Abdominal tuberculosis, which is one of the forms of extrapulmonary tuberculosis, affects the gastrointestinal tract, spleen, pancreas, liver, peritoneum, omentum and lymph nodes adjacent to these organs.
Abdominal tuberculosis could be the result of a primary infection or the reactivation of a dormant focus (post primary tuberculosis). The latter can happen due to decreased immunity levels like in the case of severe infections, HIV, malnutrition etc.
With the increasing incidence of HIV, there is a rise in extra-pulmonary tuberculosis, that is, tuberculosis that occurs outside the lungs. Abdominal tuberculosis is one of the common forms of extra-pulmonary tuberculosis. Common pathogens involved are Mycobacterium tuberculosis and Mycobacterium bovis.
Spread of abdominal tuberculosis is through blood, direct contact with primary focus or ingestion of sputum containing bacilli from the active pulmonary focus.
There are three types of abdominal tuberculosis depending upon the kind of presentation. They are:
Diagnosis of abdominal tuberculosis is often clinical, but is confirmed with tests (blood test and other investigations). Treatment is with antitubercular drugs and surgery in combination or alone depending upon individual patient requirement.
Diagnosis of abdominal tuberculosis is made with the help of Mantoux test, liver function tests, ESR, serum albumin levels, x-rays/ ultrasound / CT scan abdomen, endoscopy, colonoscopy and laparoscopy. Fine needle aspiration cytology, peritoneal biopsy, ascitic fluid assessment with PCR assay and QuantiFeron –TB test are all effective in reaching a conclusion with the diagnosis.