Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience
Abdominal tuberculosis (TB) is a rare manifestation of extrapulmonary TB. This disease entity can be overlooked, and its early diagnosis is difficult because of its variable manifestations and lack of specific symptoms. Methods: The clinical and diagnostic features, treatment, and outcome of patient...
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| Format: | Article |
| Language: | English |
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Elsevier
2009-03-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664609600528 |
| _version_ | 1818426989531365376 |
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| author | Huan-Lin Chen Ming-Shiang Wu Wen-Hsiung Chang Shou-Chuan Shih Hsin Chi Ming-Jong Bair |
| author_facet | Huan-Lin Chen Ming-Shiang Wu Wen-Hsiung Chang Shou-Chuan Shih Hsin Chi Ming-Jong Bair |
| author_sort | Huan-Lin Chen |
| collection | DOAJ |
| description | Abdominal tuberculosis (TB) is a rare manifestation of extrapulmonary TB. This disease entity can be overlooked, and its early diagnosis is difficult because of its variable manifestations and lack of specific symptoms.
Methods: The clinical and diagnostic features, treatment, and outcome of patients with abdominal TB at a major hospital in southeastern Taiwan from January 1987 to December 2006 were investigated.
Results: Twenty-one patients with abdominal TB identified during the 20-year period were included. A predominance of male (13/21, 61.9%) and Taiwanese aborigine (15/21, 71.4%) patients was noted. Middle-aged (30–50 years) patients with alcoholic liver cirrhosis had the highest risk. Common presenting features included abdominal pain (18/21, 85.7%), fever (16/21, 76.2%), ascites (13/21, 61.9%), and weight loss (12/21, 57.3%). The mean time to reach a diagnosis was 48 ± 10 days. Tuberculous peritonitis was noted in 11 patients, with a high correlation with liver cirrhosis (p = 0.0237, Fisher's exact test). The other patients were diagnosed with TB of the gastrointestinal tract (n = 6), urinary tract (n = 2), and pelvis (n = 2). Abdominal sonography and abdominal computed tomography were helpful for diagnosis, by revealing ascites and thickening of the peritoneum. Pulmonary involvement was noted in 11 patients. Most of the patients (16/21, 76.2%) improved with anti-tuberculosis therapy, and five patients died from sepsis and respiratory failure.
Conclusion: Abdominal TB is a rare manifestation of extrapulmonary TB, even in southeastern Taiwan where TB is prevalent. Delay in diagnosis is common and abdominal TB should be included in the differential diagnosis of middle-aged aborigine men with alcoholic liver cirrhosis and peritonitis. |
| first_indexed | 2024-12-14T14:38:36Z |
| format | Article |
| id | doaj.art-d6584b36870c4e88ac6183e66c918451 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-14T14:38:36Z |
| publishDate | 2009-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-d6584b36870c4e88ac6183e66c9184512022-12-21T22:57:30ZengElsevierJournal of the Formosan Medical Association0929-66462009-03-01108319520110.1016/S0929-6646(09)60052-8Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of ExperienceHuan-Lin Chen0Ming-Shiang Wu1Wen-Hsiung Chang2Shou-Chuan Shih3Hsin Chi4Ming-Jong Bair5Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Nursing and Management College, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Nursing and Management College, Taipei, TaiwanMackay Medicine, Nursing and Management College, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taipei, TaiwanAbdominal tuberculosis (TB) is a rare manifestation of extrapulmonary TB. This disease entity can be overlooked, and its early diagnosis is difficult because of its variable manifestations and lack of specific symptoms. Methods: The clinical and diagnostic features, treatment, and outcome of patients with abdominal TB at a major hospital in southeastern Taiwan from January 1987 to December 2006 were investigated. Results: Twenty-one patients with abdominal TB identified during the 20-year period were included. A predominance of male (13/21, 61.9%) and Taiwanese aborigine (15/21, 71.4%) patients was noted. Middle-aged (30–50 years) patients with alcoholic liver cirrhosis had the highest risk. Common presenting features included abdominal pain (18/21, 85.7%), fever (16/21, 76.2%), ascites (13/21, 61.9%), and weight loss (12/21, 57.3%). The mean time to reach a diagnosis was 48 ± 10 days. Tuberculous peritonitis was noted in 11 patients, with a high correlation with liver cirrhosis (p = 0.0237, Fisher's exact test). The other patients were diagnosed with TB of the gastrointestinal tract (n = 6), urinary tract (n = 2), and pelvis (n = 2). Abdominal sonography and abdominal computed tomography were helpful for diagnosis, by revealing ascites and thickening of the peritoneum. Pulmonary involvement was noted in 11 patients. Most of the patients (16/21, 76.2%) improved with anti-tuberculosis therapy, and five patients died from sepsis and respiratory failure. Conclusion: Abdominal TB is a rare manifestation of extrapulmonary TB, even in southeastern Taiwan where TB is prevalent. Delay in diagnosis is common and abdominal TB should be included in the differential diagnosis of middle-aged aborigine men with alcoholic liver cirrhosis and peritonitis.http://www.sciencedirect.com/science/article/pii/S0929664609600528abdominal tuberculosisextrapulmonary tuberculosisgastrointestinal tuberculosistuberculosistuberculous peritonitis |
| spellingShingle | Huan-Lin Chen Ming-Shiang Wu Wen-Hsiung Chang Shou-Chuan Shih Hsin Chi Ming-Jong Bair Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience Journal of the Formosan Medical Association abdominal tuberculosis extrapulmonary tuberculosis gastrointestinal tuberculosis tuberculosis tuberculous peritonitis |
| title | Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience |
| title_full | Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience |
| title_fullStr | Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience |
| title_full_unstemmed | Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience |
| title_short | Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience |
| title_sort | abdominal tuberculosis in southeastern taiwan 20 years of experience |
| topic | abdominal tuberculosis extrapulmonary tuberculosis gastrointestinal tuberculosis tuberculosis tuberculous peritonitis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664609600528 |
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