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PWE-142 A 10-year review of abdominal tuberculosis experience in a single multi-ethnic hospital population
  1. UN Shivaji1,
  2. T Critchlow1,
  3. S Pathmakanthan1,
  4. S Ghosh1,2,
  5. M Iacucci1,2,
  6. N Sharma2,3,
  7. R Cooney1,
  8. T Iqbal1,
  9. P Glynn4,
  10. N Bhala1,2
  1. 1Gastroenterology, UHB
  2. 2Institute of Translational Medicine, University of Birmingham
  3. 3Gastroenterology, Heartlands Hospital
  4. 4Respiratory Medicine, UHB, Birmingham, UK

Abstract

Introduction Tuberculosis (TB) carries significant morbidity. It is most commonly pulmonary but it can also affect the gastrointestinal (GI) tract (6% of total cases in UK). Abdominal tuberculosis (A-TB) is a rare disease which can present a unique diagnostic challenge mimicking various GI diseases. We reviewed a 10 year cumulative regional TB database to report results on this unusual condition.

Method A retrospective review of patients diagnosed with A-TB between 2006 & 2016 in a single tertiary centre in South Birmingham covering a multi-ethnic urban population of ~7 50 000. A central surveillance database managed by Respiratory Physicians and Public Health England was used to identify patients with A-TB. We reviewed clinical data from electronic records including radiology, chemical pathology, histopathology, endoscopy databases, surgical notes and letters.

Results Of 41 patients [M=22 (54%);mean age 42y (SD ±17y)] identified with A-TB, 17 (41%) were Pakistani, 6 (15%) were other Asian and 8 (19%) were Afro-Caribbean with no data on country of origin or ethnicity recorded for the remainder. Thirty three (80%) were residents of economically deprived areas of Birmingham which were among the 10% of most deprived constituencies in UK, with an overall lowest national decile of 1#.(# Index of multiple deprivation as per local council)

The most frequently reported symptoms were abdominal pain (n=23; 56%), weight loss (n=17; 41%), fever (n=10; 24%) and vomiting (n=9; 22%). Twelve (29%) patients were first seen in the surgical clinic and 9 (22%) in a medical gastroenterology clinic. A-TB was confirmed on tissue biopsy in 24 (58%) of which 2 were post-bowel resection. Seventeen (41%) patients had positive cultures with full drug sensitivity and only 5 (12%) patients had polymerase chain reaction (PCR) tests. Eight patients (20%) had concurrent pulmonary TB. Thirty seven patients (90%) received full, successful treatment for A-TB.

Conclusion Asian ethnicity and low socioeconomic status appear to be risk factors for A-TB in a single tertiary centre. Histological diagnosis at endoscopic or surgical biopsy is a reliable diagnostic tool for confirming TB. Both gastroenterologists and surgeons need to consider A-TB in their differentials, as once diagnosed, most are successfully treated.

Disclosure of Interest None Declared

  • abdominal tuberculosis
  • TB
  • tuberculosis

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