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Abdominal tuberculosis

Author
Vineet Ahuja, MD, DM
Section Editors
Sanjiv Chopra, MD, MACP
C Fordham von Reyn, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Abdominal tuberculosis (TB) includes involvement of the gastrointestinal tract, peritoneum, lymph nodes, and/or solid organs [1-4]. Abdominal TB comprises around 5 percent of all cases of TB [5].

Issues related to TB involving the intestinal tract, peritoneum, and liver will be reviewed here; issues related to clinical manifestations, diagnosis, and treatment of pulmonary TB are discussed separately. (See "Clinical manifestations and complications of pulmonary tuberculosis" and "Diagnosis of pulmonary tuberculosis in HIV-uninfected adults" and "Treatment of drug-susceptible pulmonary tuberculosis in HIV-uninfected adults".)

RISK FACTORS

Risk factors for development of abdominal TB include cirrhosis, HIV infection, diabetes mellitus, underlying malignancy, treatment with anti-tumor necrosis factor (TNF) agents, and use of peritoneal dialysis [6-10]. Issues related to the epidemiology of TB are discussed further separately. (See "Epidemiology of tuberculosis".)

FORMS OF DISEASE

Abdominal TB can present with involvement of any of the following sites: peritoneum, esophagus, stomach, intestinal tract, hepatobiliary tree, pancreas, perianal area, and lymph nodes. The most common forms of disease include involvement of the peritoneum, intestine, and/or liver.

Tuberculosis of the abdomen may occur via reactivation of latent TB infection or by ingestion of tuberculous mycobacteria (as with ingestion of unpasteurized milk or undercooked meat). In the setting of active pulmonary TB or miliary TB, abdominal involvement may develop via hematogenous spread via contiguous spread of TB from adjacent organs (such as retrograde spread from the fallopian tubes) or via spread through lymphatic channels [2].

                       
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Literature review current through: Sep 2017. | This topic last updated: Sep 29, 2017.
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