ABDOMINAL TUBERCULOSIS

ABDOMINAL TUBERCULOSIS
Tuberculosis is one of old widely present communicable disease present in India. The primary site of infection is lungs.
But the disease may or not show up every time as lung tuberculosis.
Tuberculosis enters our body through lungs but has a capacity to spread to various organs (secondary tuberculosis). This leads to tuberculosis of various organs such as tuberculosis of intestine, spine, kidney and others.

Causes of abdominal tuberculosis
Abdominal tuberculosis is mostly in form of-
Ingestion of TB infected droplet
Secondary tuberculosis (spread from lung tuberculosis)
A patient of lung tuberculosis if untreated may develop tuberculosis of any organ including abdominal tuberculosis. The point to be noted is that not all patients of lung tuberculosis may have symptoms. And even if they have symptoms, there are chances that symptoms may only be minimal, consisting of minor fever or cough which may reduce spontaneously in couple of days.

Location
The most common locations of abdominal tuberculosis are
end part of ileum
last part of small intestine
the junction of ileum and caecum
point connection between small intestine and large intestine
Apart from above mentioned sites, some other sites of abdominal tuberculosis can be-
Large intestine
Jejunum
(middle part of small intestine)
Anal canal
Duodenum
part of small intestine immediately after stomach
Stomach
Esophagus
(food pipe)

Symptoms
Tuberculosis of any organ gives rise to general symptoms such as-
Fever
Night sweat
Fever with chills
Weight loss
The general symptoms of tuberculosis may also be present in a patient of lung tuberculosis or tuberculosis of any other organ. These are not specific of tuberculosis of any organs. Moreover, these symptoms can also be present in other diseases. Hence never indicate tuberculosis individually.
Abdominal Tuberculosis at any point leads to ulcer and inflammatory reactions leading to formation of mass and swelling of lymph nodes around that area.
Apart from the above mentioned general symptoms , some symptoms which are seen in abdominal tuberculosis may be-
Abdominal pain (most common)
Diarrhea
Sub acute intestinal obstruction
Foul smelling Stools
Stool mixed with blood
The symptoms of tuberculosis are not specific to abdominal tuberculosis in most of the cases.
Some patients may present with just one or all of the above mentioned symptoms. Even the severity and progression of symptoms may range greatly from one patient to another.
The diagnosis is done mainly on the physicians clinical expertise and investigations advised.

Complications
As discussed above Abdominal tuberculosis presents with various grades and severity of symptoms. But is any of the symptom is ignored for long time, it may lead to complications at the site of tuberculosis
Malabsorption
inability to absorb nutrients present in food
this is due to loss of functioning of affected site
Intestinal perforation
the lesion may lead to thinning of abdominal wall and this may lead to perforation
the ulcer formed at the site leads to thinning of the wall
this in long run can lead to perforation
Ascites
the inflammatory reactions present in the area around can lead to diffusion of fluid in the surrounding area leading to fluid accumulation in abdominal cavity
Pyoperitonium
the inflammatory reactions around the lesion may lead to puss accumulation in abdominal cavity

Investigations
Ultra-sonography
Ct scan
Barium study
Biopsy using colonoscopy
The required investigation should be done according to advise by the physician.

Treatment
The patient is started on Anti Tuberculosis Treatment (ATT) regimen as instructed by his/her physician after the required investigations
In some cases, if the lesion has lead to formation of constriction or ulcer or necrosis, Surgery may be required.

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