Diagnostic dilemmas in abdominal tuberculosis in children

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dc.contributor.authorSaczek K.B.
dc.contributor.authorSchaaf H.S.
dc.contributor.authorVoss M.
dc.contributor.authorCotton M.F.
dc.contributor.authorMoore S.W.
dc.date.accessioned2011-05-15T16:17:43Z
dc.date.available2011-05-15T16:17:43Z
dc.date.issued2001
dc.description.abstractThe authors review 45 pediatric patients with intra-abdominal tuberculosis (ATB) treated between May 1990 and April 1998. The diagnosis was confirmed histologically or by positive culture for Mycobacterium tuberculosis. Clinical presentation was with an abdominal mass (12), subacute obstruction (11), ascites (5), mass and ascites (4), peritonitis (4), and 9 unusual presentations. Mantoux tests were positive in 68% of patients tested. There were radiologic features suggestive of pulmonary TB in 29 patients (64%); abnormal abdominal radiographs were recorded in 21 (47%). Lymphadenopathy was noted on abdominal ultrasound in 23 of 30 patients (77%) and on computed tomography scan in a further 3 of 8 patients investigated. Ascitic fluid adenosine deaminase (ADA) levels were greater than 30 IU/1 in 3 of 4 patients (75%), suggesting ATB. All 28 patients screened for human immunodeficiency virus were negative. A surgical procedure was performed in 39 patients, 29 (74%) had an elective diagnostic laparotomy for tissue diagnosis. One (3.4%) developed a postoperative intra-abdominal abscess. Ten (26%) presented with complications requiring surgical intervention including perforated viscus, segmental bowel resection, strictureplasty, adhesiolysis, or ileostomy. One of the latter died due to sepsis after having complications of persistent intestinal obstruction and cecal perforation. The authors recommend an aggressive approach to patients with suspected ATB in order to obtain an early definitive diagnosis, prevent complications, and reduce morbidity and mortality. They emphasize the importance of tissue diagnosis and confirmation by culture.
dc.description.versionArticle
dc.identifier.citationPediatric Surgery International
dc.identifier.citation17
dc.identifier.citation2-3
dc.identifier.issn01790358
dc.identifier.other10.1007/s003830000455
dc.identifier.urihttp://hdl.handle.net/10019.1/14341
dc.subjectabdominal infection
dc.subjectabdominal mass
dc.subjectarticle
dc.subjectascites
dc.subjectbacterium culture
dc.subjectclinical article
dc.subjectclinical feature
dc.subjectdiagnostic approach route
dc.subjectearly diagnosis
dc.subjecthistopathology
dc.subjecthuman
dc.subjectinfant
dc.subjectintestine perforation
dc.subjectMycobacterium tuberculosis
dc.subjectperitonitis
dc.subjectpriority journal
dc.subjectsepsis
dc.subjectsurgical approach
dc.subjecttuberculin test
dc.subjecttuberculosis
dc.subjectAbdominal abscess
dc.subjectAlgorithms
dc.subjectBiopsy
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant
dc.subjectLymph nodes
dc.subjectMale
dc.subjectPeritoneum
dc.subjectPeritonitis, Tuberculous
dc.subjectPostoperative complications
dc.subjectReoperation
dc.titleDiagnostic dilemmas in abdominal tuberculosis in children
dc.typeArticle
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