PRESENTATION AND PATTERN OF ABDOMINAL TUBERCULOSIS IN A TERTIARY CARE HOSPITAL

Introduction: Tuberculosis is a multisystemic infectious, necrotic, granulomatous disease caused by mycobacteria, mainly Mycobacterium tuberculosis, and is a common problem in Pakistan. The lungs are mostly affected, but any tissue may be affected. The incidence of extrapulmonary tuberculosis has increased in recent years, and abdominal tuberculosis is the most common type of extrapulmonary tuberculosis. So, this is a descriptive intervention study conducted to understand the pattern and presentation of abdominal tuberculosis, creating a local diagnosis guide to minimize both underdiagnosis and over diagnosis. Place and Duration: In the Chest Medicine Department of Holy Family Hospital, Rawalpindi for on-year duration from July 2019 to July 2020. Methods: 38 patients were enrolled in this study, 57% male and 43% female. The presented symptoms were abdominal pain in 57%, fever 50%, weight loss 43%, abdominal distension 21%, diarrhea 7%, vomiting 7%, respiratory symptoms in half of the patients, and pulmonary tuberculosis in only 14%. Results: Leukopenia occurs in 36% of patients and leukocytosis in 36%. Features of anemia are present in 64%: 46% of them are normocytic, normochromic anemia, 18% of iron deficiency anemia, 43% of thrombocytosis and 21% of thrombocytopenia. 93% low serum albumin and normal liver enzymes in all patients. The Mantoux test was 57% positive and 43% negative. Abdominal U / S showed ascites in 36%, enlarged perithoracic and mesenteric lymph nodes in 29%, enlargement of the liver and splenomegaly 14%, ileocecal mass 7%, peritoneal fusion 7% and lumbar abscess 7%. Ascites appeared as exudate in 93% of patients and as exudative in 7%. CXR showed features of old PTB in 43% of patients. The characteristics of tuberculosis are ascites 36%, tabes mesentrica 29%, hepatosplenomegaly 14%, intestinal obstruction 14% and psoas abscess 7%. Keywords: presentation, pattern, abdomen, tuberculosi