Usama Bin Abid, Rashid Nawaz, Talha Shamshad
Objectives: To highlight the importance of the rapidly spreading abdominal tuberculosis and raise concern in the medical community about its different presentation. Material: This is a prospective study of 250 cases of abdominal tuberculosis conducted at the surgical Units of Allied Hospital, Faisalabad for one-year duration from October 2019 to September 2020. Results: A total of 250 patients were treated during the study period, with women being the overwhelming majority of 58% (145). The mean age was 37.5 years and chronic abdominal pain was the main symptom in 65.6% (164) of patients, followed by weight loss and evening fever. 70% of patients had Hb <10 g / dl and ESR elevated above 20 mm / h in 61.2%. The chest X-rays were mostly inconclusive, and the abdominal X-rays showed non-specific results. Abdominal ultrasound was dominated by ascites 14.8% (37), mass right iliac fossa 11.6% (29) and distended intestinal loops in 18% (45). The CT examination additionally confirmed the ultrasound results. In 130 patient’s laparoscopies was performed and 86 underwent laparotomy with adhesions. The most common perioperative symptoms were bands 39.2% (51), followed by ascites in 28.4% (37). The histopathology of the biopsy specimen revealed chronic granulomatous inflammation in 115 cases, the rest were nonspecific. All patients underwent standard 4-drug anti-tuberculosis therapy and were regularly monitored. The mortality rate was 1.2%, while 98.8% of the patients completely recovered. Conclusion: The final diagnosis of abdominal tuberculosis is difficult due to its non-specific presentation and the lack of pathognomonic imaging and histopathological results. Key words: Chronic abdominal pain, tuberculosis, anti-tuberculosis therapy, diagnostic laparoscopy.