Abdominal tuberculosis in children. A survey of cases at the Red Cross War Memorial Children's Hospital, 1976-1985.

Fifty-nine cases of abdominal tuberculosis were seen at the Red Cross War Memorial Children's Hospital, Cape Town, during the period 1976-1985. More than half these patients were under 4 years of age and all were malnourished. Mesenteric adenitis and/or peritoneal involvement accounted for the majority of cases and only 8 patients with proven gastro-intestinal lesions were seen. The diagnosis of suspected abdominal tuberculosis is relatively easily made since abdominal distension occurs in almost all patients. More than half have an abdominal mass, a chest radiograph suggestive of tuberculosis, a positive Mantoux skin test or a combination of these as supportive evidence for the diagnosis. Over a quarter of the patients presented with signs suggestive of intestinal obstruction. Response to antituberculosis therapy is excellent. Stricture formation on healing may occur in a minority of patients with the enteric form of the disease. Providing it is not part of disseminated tuberculosis in a grossly malnourished young child, the prognosis with treatment for abdominal tuberculosis is satisfactory.