[Treatment of abdominal tuberculosis : Background, diagnostics and treatment of a global problem]

Chirurg. 2019 Oct;90(10):818-822. doi: 10.1007/s00104-019-0999-9.
[Article in German]

Abstract

Background: Tuberculosis (TB) is among the 10 leading causes of global deaths and is a special threat to immunocompromised patients with human immunodeficiency virus (HIV). Due to migration from endemic areas cases in central Europe can also increase.

Objective: This article gives an overview of background information, detection methods, treatment and the role of surgery in abdominal manifestation of a systemic infection.

Material and methods: A PubMed search was carried out using the following keywords: abdominal TB, incidence, symptoms, diagnostics, treatment and surgery.

Results: The detection of TB in cases of abdominal manifestation can be carried out via percutaneous biopsy; however, laparoscopy is recommended due to the better detection rate, low complication rate and its ability to differentiate other diseases, such as peritoneal carcinomatosis and lymphomas. Antituberculous drugs are the primary treatment. An acute abdomen can occur in up to approximately 30% of cases. Complications such as strictures and perforations require surgical treatment.

Conclusion: Although the prevalence of TB is decreasing, the infection causes more than 1 million deaths per year. The correct diagnosis can be impeded by a misleading clinical presentation. A multidisciplinary approach enables rapid and efficient diagnostics and treatment.

Keywords: Abdominal manifestation; Acute abdomen; Laparoscopy; Mycobacterium tuberculosis; Strictures.

Publication types

  • Review

MeSH terms

  • Abdomen
  • Abdomen, Acute / microbiology
  • Antitubercular Agents / therapeutic use*
  • Diagnosis, Differential
  • Europe
  • Humans
  • Immunocompromised Host*
  • Tuberculosis* / diagnosis
  • Tuberculosis* / drug therapy
  • Tuberculosis* / surgery
  • Tuberculosis, Gastrointestinal / diagnosis
  • Tuberculosis, Gastrointestinal / surgery

Substances

  • Antitubercular Agents