Abdominal tuberculosis in urban Britain--a common disease.

K R Palmer, D H Patil, G S Basran, J F Riordan, D B Silk

Between 1973 and 1983 abdominal tuberculosis was responsible for the admission of 90 patients to a west London district general hospital. Over the same period Crohn's disease was newly diagnosed in 102 hospitalised patients. In contrast with Crohn's disease, the majority (75) of tuberculous patients were Asian immigrants. Mean duration of residence in the United Kingdom was 4 +/- 0.9 (SD) years, and mean age at presentation was 34.9 +/- 1.1 years. Forty per cent of tuberculosis patients presented as an acute emergency to physicians, surgeons, or gynaecologists while the remainder presented a more insidious, chronic picture. Five groups of tuberculous patients were recognised. Forty two subjects had intestinal tuberculosis characterised by pain (100%), abdominal mass (43%) and abnormal contrast radiology (100%). Ten of these underwent emergency laparotomy for intestinal obstruction or perforation. Twenty seven patients had tuberculous peritonitis although only 16 had ascites. Eight patients presented with pyrexia and granulomatous hepatitis. Five had pulmonary and abdominal tuberculosis. The remaining eight patients represented a miscellaneous group. The diagnosis of abdominal tuberculosis was established histologically (60 cases), bacteriologically (six cases) or radiologically (24 cases). Chest radiograph, tuberculin skin testing and paracentesis were usually unhelpful. Five severely ill patients died. The remainder recovered completely after specific triple chemotherapy and response to treatment was usually evident within 14 days. In urban Britain tuberculosis is an important cause of abdominal disease. Prognosis is excellent following specific therapy.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Ramesh, J., Banait, G.S., Ormerod, L.P. (2008). Abdominal tuberculosis in a district general hospital: a retrospective review of 86 cases. QJM 101: 189-195 [Abstract] [Full Text]  
• Kirsch, R, Pentecost, M, de M Hall, P, Epstein, D P, Watermeyer, G, Friederich, P W (2006). Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis.. J. Clin. Pathol. 59: 840-844 [Abstract] [Full Text]  
• Long, R., Gardam, M. (2003). Tumour necrosis factor-{alpha} inhibitors and the reactivation of latent tuberculosis infection. CMAJ 168: 1153-1156 [Full Text]  
• Lim, W. S., Powell, R.J., Johnston, I.D., Zhang, Z., Correa, H., Begue, R. E., De Rosa, F. G., Bonora, S., Di Perri, G., Myers, A., Clark, J., Foster, H., Riminton, S., Pearce, N., Basten, A., Keane, J., Gershon, S. K., Braun, M. M. (2002). Tuberculosis and Treatment with Infliximab. NEJM 346: 623-626 [Full Text]  
• Saltzman, J. R., Compton, C. C. (1999). Case 34-1999- A 37-Year-Old Woman with Liver Disease and Recurrent Diarrhea. NEJM 341: 1530-1537 [Full Text]  
• Pulimood, A B, Ramakrishna, B S, Kurian, G, Peter, S, Patra, S, Mathan, V I, Mathan, M M (1999). Endoscopic mucosal biopsies are useful in distinguishing granulomatous colitis due to Crohn's disease from tuberculosis. Gut 45: 537-541 [Abstract] [Full Text]  
• Cook, G.C. (1992). Some Medical Problems Affecting the Ethnic Minorities of the UK. The Journal of the Royal Society for the Promotion of Health 112: 137-142 [Abstract]