Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.
Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia.
Indian J Tuberc. 2021 Apr;68(2):236-241. doi: 10.1016/j.ijtb.2020.09.007. Epub 2020 Sep 12.
Abdominal tuberculosis (ATB) is the second most common type of extra-pulmonary tuberculosis. Though it does not usually pose a significant risk of infectivity, ATB can go unidentified and progress to disseminated infection. The aim of this study is to highlight the incidence and outcome of this infection in a tertiary care centre in the Kingdom of Saudi Arabia (KSA).
In this retrospective study, we included all ATB patients admitted to our centre between January 1 , 2010 and December 31, 2018. A total of 42 patients with a median age of 49 (range 18-83 years, 78.6% males) were identified.
The most common presentation was abdominal pain, weight loss, and abdominal distension. All the patients were HIV negative; however, 50% had a comorbid condition, mainly diabetes mellitus, chronic renal failure, and liver cirrhosis. Tuberculous peritonitis was the predominant type of ATB. Suspicious and potentially malignant abdominal masses appeared on the abdominal CT scans of six patients. This suggest that TB should be excluded in patients from endemic area presenting with abdominal masses. All patients received standard anti-tuberculous medication for an average duration of 7.4 months. The outcome was excellent with 88%% achieving complete response. Adjunctive corticosteroids were not used, and none of the patients had a surgical complication.
The diagnosis of ATB is challenging. It can mimic inflammatory bowel disease in young populations and malignancy in middle-aged and elderly population. For this reason, a high index of suspicion with prompt treatment is required to improve the prognosis and prevent complications.
腹部结核（ATB）是仅次于肺部的第二大类型的肺外结核。尽管它通常不会造成显著的传染性风险，但 ATB 可能会被漏诊，并发展为播散性感染。本研究旨在强调沙特阿拉伯王国（KSA）一家三级护理中心中这种感染的发生率和结果。
在这项回顾性研究中，我们纳入了 2010 年 1 月 1 日至 2018 年 12 月 31 日期间在我们中心住院的所有 ATB 患者。共确定了 42 名中位年龄为 49 岁（范围 18-83 岁，78.6%为男性）的患者。
最常见的表现是腹痛、体重减轻和腹胀。所有患者均为 HIV 阴性；然而，50%的患者存在合并症，主要是糖尿病、慢性肾衰竭和肝硬化。结核性腹膜炎是 ATB 的主要类型。6 名患者的腹部 CT 扫描上出现可疑和潜在恶性的腹部肿块。这表明，对于来自流行地区、出现腹部肿块的患者，应排除结核病。所有患者均接受了为期 7.4 个月的标准抗结核药物治疗。结果极好，88%的患者完全缓解。未使用辅助皮质类固醇，且无患者发生手术并发症。
ATB 的诊断具有挑战性。它可能在年轻人群中类似于炎症性肠病，在中年和老年人群中类似于恶性肿瘤。因此，需要高度怀疑并及时治疗，以改善预后并预防并发症。
