Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Department of Pediatric Sciences, Giannina Gaslini Institute, University of Genoa, Italy.
J Pediatric Infect Dis Soc. 2020 Apr 30;9(2):218-227. doi: 10.1093/jpids/piz093.
The diagnosis of abdominal tuberculosis (TB) is challenging, and the prevalence of abdominal TB in children is likely underestimated. It may present with nonspecific abdominal symptoms and signs, but children who present with pulmonary TB may have additional abdominal subclinical involvement. Diagnosis is specifically challenging because none of the available diagnostic tools provide adequate sensitivity and specificity. In this review, we summarize the best available evidence on abdominal TB in children, covering the epidemiology, pathogenesis, clinical presentation, diagnosis, and treatment. We propose a diagnostic approach that could be followed for symptomatic children. We believe that a combination of investigations could be useful to both aid diagnosis and define the extent of the disease, and we propose that abdominal ultrasound should be used more frequently in children with possible TB and any abdominal symptoms. This neglected disease has received little attention to date, and further research is warranted.
腹腔结核病（TB）的诊断具有挑战性，且儿童腹腔结核病的患病率可能被低估。其可能表现为非特异性腹部症状和体征，但出现肺结核的儿童可能会有额外的腹部亚临床受累。诊断特别具有挑战性，因为目前尚无任何诊断工具具有足够的敏感性和特异性。在这篇综述中，我们总结了儿童腹腔结核病的最佳现有证据，涵盖了流行病学、发病机制、临床表现、诊断和治疗。我们提出了一种针对有症状儿童的诊断方法。我们认为，综合使用各种检查方法可能有助于辅助诊断和确定疾病的范围，我们建议在可能患有结核病和任何腹部症状的儿童中更频繁地使用腹部超声检查。这种被忽视的疾病迄今尚未得到太多关注，需要进一步研究。
