Clinicopathological Profile Analysis of Patients with Abdominal Tuberculosis in Bangladesh: A Single Center Study
Published: 2023-11-06
Page: 137-143
Issue: 2023 - Volume 6 [Issue 1]
Mostofa Showkat Imran *
Department of Gastroenterology, Ibn Sina Medical College & Hospital, Dhaka, Bangladesh.
Amitav Saha
Department of Gastroenterology, Dhaka Medical Hospital, Dhaka, Bangladesh.
Syeda Meherunnesa
Department of Obstetrics & Gynecology, Ad Din Medical College & Hospital, Dhaka, Bangladesh.
Alamgir Haider
Department of Anaesthesia, Aichi Medical College & Hospital, Dhaka, Bangladesh.
Nigar Sultana
Department of Gastroenterology, Delta Medical College & Hospital, Dhaka, Bangladesh.
Md. Reaz Uddin Chowdhury
Department of Internal Medicine, Abdul Malek Ukil Medical College & Hospital, Noakhali, Bangladesh.
Taslima Zaman
Department of Gastroenterology, United Hospital Ltd., Dhaka, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: To analyze the clinicopathological profile of abdominal tuberculosis patients among 73 patients in a tertiary care hospital in Bangladesh.
Objective: To analyze the clinicopathological profileof abdominal tuberculosis patients.
Methods: It was crosssectional obsevetional study, executed in the Department of Gastroenterology Dhaka Medical College Hospital (DMCH) in collaboration with National Tuberculosis Reference Laboratory, NIDCH, Mohakhali, Dhaka from May 2015 to April 2016. Seventy-three cases of abdominal tuberculosis were studied, which were operatedonand diagnosed. Data collection included detailed history, particularly age distribution, site of abdominal tuberculosis involvement, and distribution of histopathology.
Results: Mean age of the study subject was 33.90 ± 15.14 years (range 18-70 years). The majority of the patients (53.2%) were between 18-30 years age group, followed by 18.8% between 31-40 years age group.Based upon predominant clinical features and investigations, the site of abdominal TB involvement was intestinal in 50(68.8%), peritoneal in 18(25%), and nodal in 5(6.2%) patients. Histopathology was performed in 60(81.25%) patients and showed granulomatous inflammation consistent with TB in 27/60(46.2%) specimens. Among them non-caseating, granuloma was found in 20(75%) specimens, caseating granuloma in 7(25%) specimens and TB bacilli (AFB) was not found in any (0.0%) specimen.
Conclusion: Young age at presentation, delayed presentation, poverty, and high morbidity and mortality are among the hallmarks of the disease in this region. These challenges need to be addressed to deliver optimal care for these patients. Early diagnosis, early anti-tuberculous therapy, and surgical treatment of the associated complications are essential for survival.
Keywords: Abdominal tuberculosis, clinicopathological profile, outcome, surgical treatment
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References
Butt T, Karamat KA, Ahmad RN, Mahmood A: Advances in diagnosis of tuberculosis. Pak J Pathol. 2001;12:1-3.
Lonnroth K, Raviglion M: Global epidemiology of tuberculosis: Prospects for control. Semin Respir Crit Care Med. 2008;29:481.
Dolin PJ, Raviglione MC, Kochi A: Global tuberculosis incidence and mortality during 1990–2000. Bull World Health Organ. 1994;72:213-20.
Addison NV. Abdominal tuberculosis: A disease revisited. Ann R Coll Surg Eng. 1983;65:105-11.
Mackie, Mc Cartney. Practical medical microbiology. 13th Edition. 1985;1:286.
Fielding LP, Peronikoff BJ. Hamilton bailey's emergency surgery. 12th Edition. 1995;425.
Raviglione MC, Snider Jr DE, Kochi A. Global epidemiology of tuberculosis: Mortality and morbidity of a worldwide epidemic. JAMA. 1995;273:220e6.
Centers for disease control and prevention: Case definitions for infectious conditions under public health surveillance. MMW R Morb Mortal Wkly Rep. 1997;46:1-55.
National Tuberculosis Control Programme (NTP). Tuberculosis control in Bangladesh. Annual Report 2015. Dhaka: Director general of health services; 2015.
United Nations sustainable development agend Available:http://www.un.org/sustainabledevelopment/development-agenda/ [Accessed on Nov 2016]
World Health Organization (WHO). Global Tuberculosis Report. Geneva: WHO; 2015.
Khan MR, Khan IR, Pal KNM: Diagnostic issues in Abdominal Tuberculosis. J Pak Med Assoc. 2001;51:138-140.
Bro HA, Rukhsana, Ara J, Hussain S. Abdominal tuberculosis: Presentation and early diagnosis. J Surg Pak. 1998;3:2-5.
Wang HS, Chen WS, Su WJ, Lin JK, Lin TC, Jiang JK: The changing pattern of intestinal tuberculosis: 30 years'experience. Int J Tuberc Lung Dis. 1998;2:569-574.
Misra SP, Misra V, Dwivedi M, Gupta SC: Colonic tuberculosis: clinical features, endoscopic appearance and management. J Gastroenterol Hepatol. 1999;14:723-729.
Singhal A, Gulati A, Frizell R, Manning AP: Abdominal tuberculosis in Bradford, UK: 1992–2002. Eur J GastroenterolHepatol. 2005;17:967-971.
Sharma MP, Bhatia V: Abdominal tuberculosis. Indian J Med Res. 2004;120:305-15.
Shaikh MS, Dholia KR, Jalbani MA: Prevalence of intestinal tuberculosis in cases of acute abdomen. Pakistan J Surg. 2007;23:52-56.
Engin G, Balk E: Imaging findings of Intestinal Tuberculosis. J Comput Assist Tomogr. 2005;29:37-41.
Rajpoot MJ, Memon AS, Rani S, Memon AH: Clinicopathological profile and surgical management outcomes in patients suffering from intestinal tuberculosis. J LiaqautUni Med Health Sci. 2005;4:113-118.
Gondal KM, Khan AFA: Changing pattern of abdominal tuberculosis. Pak J Surg. 1995;11:109-113.
Ibrarullah M, Mohan A, Sarkari A, Srinivas M, Mishra A, Sundar TS. Abdominal tuberculosis: diagnosis by laparoscopy and colonoscopy.Tropical gastroenterology: official journal of the Digestive Diseases Foundation. 2001;23(3):150-153.
Bhargava DK, Chopra P, Nijhawan S, Dasarathy S, Kushwaha AK. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. American Journal of Gastroenterology. 1992;87(1):109-12.
Sia IG, Wieland ML. Current concepts in the management of tuberculosis. In Mayo Clinic Proceedings. 2011;86(4):348-361.
Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn's disease: a diagnostic challenge. The American journal of gastroenterology. 2009;104(4):1003-1012.
Samant H, Desai D, Abraham P, Joshi A, Gupta T, Rodrigues C et al. Acid-fast bacilli culture positivity and drug resistance in abdominal tuberculosis in Mumbai, India. Indian Journal of Gastroenterology. 2014;33(5):414-419.
Khan R, Abid S, Jafri W, Abbas Z, Hameed K, Ahmad Z. Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians. World Journal of Gastroenterology. 2006;12(39):6371.
Kapoor VK. Abdominal tuberculosis. Postgraduate medical journal. 1998;74(874):459-467.
Anuradha B, Aparan S, Hari SPV, Vijaya LV, Akbar Y, Suman LG: Prevalence of drug resistance under the DOTs Strategy in Hyderabad South India, 2001–2003. Int J Tuberc Lung Dis. 2006;10:58–62.
Kapoor VK. Abdominal tuberculosis. Postgrad Med J. 1998;74:459-6.
Gorbach SL. Infectious diarrhea and bacterial food poisoning. Gastrointestinal disease. 1993;2:1128-1189.
Vadwai V, Boehme C, Nabeta P, Shetty A, Alland D, Rodrigues C, et al. Xpert MTB/RIF: A new pillar in diagnosis of extrapulmonary tuberculosis?. Journal of clinical microbiology. 2011;49(7):2540-2545.
Rasheed S, Zinicola R, Watson D, Bajwa A, Mc Donald PJ. Intra‐abdominal and gastrointestinal tuberculosis. Colorectal Disease. 2007;9(9):773-783.
Al-Quorain AA, Satti MB, Al-Freihi HM, Al-Gindan YM, Al-Awad N. Abdominal tuberculosis in Saudi Arabia: a clinicopathological study of 65 cases. American Journal of Gastroenterology. 1993;88(1):75-79.