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Year 2019

Volume: 6 , Issue: 3

Print ISSN:-2394-6784

Online ISSN:-2394-6792

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Indian Journal of Pathology and Oncology


Abdominal Tuberculosis in Uttarakhand: A diagnostic Dilemma


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Author Details: Deepa Hatwal, Arvind Kumar, Neha Batra

Volume : 4

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 188

Article End Page : 192


Abstract

Background: Abdominal tuberculosis has become one of the leading cause of morbidity and mortality. It can involve any part of gastrointestinal tract. It is a major public health problem in developing countries. Abdominal tuberculosis still presents a diagnostic challenge as clinical symptoms are nonspecific and mimic various gastrointestinal disorders.
Aim: To analyse role of various clinical, histopathological and microbiological findings in confirming the diagnosis of abdominal tuberculosis.
Materials and Method: A retrospective study was carried out in a tertiary teaching hospital in Uttarakhand and all cases diagnosed as abdominal tuberculosis were included in the study. All relevant data were collected from medical records. Histopathological examination along with Ziehl-Neelsen staining was done in all the cases to detect acid fast bacilli.
Results: Out of the 68 cases of abdominal tuberculosis, intestinal tuberculosis had highest incidence of 45.59%, out of which ileum was the most frequent site .This was followed by peritoneal tuberculosis (33.82%) and nodal tuberculosis (14.71%). Stricture was seen in 41.18% cases. It was seen that in intestinal tuberculosis caseating granuloma had 29.03% positivity for acid fast bacilli while non-caseating had a positivity of 12.90%. In lymph node tuberculosis acid fast positivity was 40% in caseating and 10% in non-caseating granuloma. Adenosine deaminase (ADA) level was raised in 100% cases of ascitic type peritoneal tuberculosis. Majority of the patients were in the age group of 21 to 40 years. Abdominal pain was the most common symptom observed in all cases (100%) of abdominal tuberculosis.
Conclusion: Significant variations are seen in the clinical presentation of abdominal tuberculosis. Symptoms are non-specific and diagnostic criterias are limited. Advanced tests are required to diagnose the disease accurately. However, in a low resource setting tissue biopsy is the ultimate tool for diagnosis of abdominal tuberculosis.

Keywords:
Gastrointestinal, Histopathology, Epithelioid Granuloma, Acid Fast Bacilli