Management of Abdominal Tuberculosis in a Community-Based Hospital From a High-Income Developing Country

Abstract Background: The delayed diagnosis and management of abdominal tuberculosis increases its mortality. We aimed to study the clinical presentation, management, and outcome of patients who had abdominal tuberculosis and treated at Al-Ain Hospital, Al-Ain City, United Arab Emirates. Methods: All patients who had abdominal tuberculosis and treated at Al-Ain Hospital between January 2011 and December 2018 were studied. Data were collected retrospectively using a structured protocol including demography, clinical presentation, diagnostic methods, management, and outcome. Results: Twenty-four patients having a median age of 30 years were studied with an incidence of 0.6/100,000 population. The most common symptoms were abdominal pain (95.8%) and malaise (79.2%). Fever was present only in nine patients (37.5%). Laboratory investigations, except the polymerase chain reaction immunoassay, were not helpful. Chest X-ray was abnormal in three patients (12.5%). Ultrasound and abdominal CT scan were nonspecific. Thirteen patients needed surgical intervention for diagnosis or therapy. Diagnosis was confirmed by histopathology in 15 patients (62.5%), immunological assays in 7 patients (29.2%), microbiological culture in one patient (4%), and therapeutic trial in one patient (4%). The most common type of abdominal tuberculosis was gastrointestinal in 13 patients (54.2%) followed by free wet peritonitis in five patients (20.8%). All patients had quadruple anti-tuberculous therapy for a minimum of six months. The median hospital stay was 6.5 days. None of our patients died. Conclusions: Diagnosis of abdominal tuberculosis remains challenging despite advancements in medical technology and diagnostic tools. The low percentage for the need for diagnostic therapy in our study supports the benefit of PCR assay. Surgery was mainly indicated as the last option to reach the diagnosis or to treat complications.