Abdominal tuberculosis in children: a systematic review on current advances.

AIM: To study the published literature on abdominal tuberculosis in children in the last 10 years.

METHOD: A PubMed search was done on 27th March 2025 with keywords "pediatric abdominal tuberculosis", using the filter of last 10 years. The articles were screened for relevance and the data were compiled on gender, age, presenting complaints, diagnosing criteria, associated pathologies, surgical management, complications and outcomes.

RESULTS: The search yielded 194 articles. After screening for relevance, 143 articles were excluded. 51 articles were studied. A total of 807 cases were studied in 51 articles, with female preponderance. The largest series was of 218 children. The age was predominantly in the adolescent period. The youngest child was an 8-day neonate with congenital tuberculosis. Predominant symptoms included fever, pain abdomen, abdominal distension, constipation, diarrhea, ascites and weight loss. Unusual presentations included splenic microabscess, liver abscess in HIV positive cases, deep vein thrombosis, mesenteric artery stenosis and intracranial sinus thrombosis. Mycobacterial cultures showed 50-75% positivity. Concomitant pulmonary tuberculosis was reported in 6 studies. The management included medical with or without surgical management. The main indication for surgical management was intestinal perforation.

CONCLUSION: Pediatric abdominal tuberculosis is an enigma due to the vague symptoms and needs to be differentiated from other conditions.