Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience

Please use this identifier to cite or link to this item: http://ntur.lib.ntu.edu.tw/handle/246246/233662

Title:	Abdominal Tuberculosis in Southeastern Taiwan: 20 Years of Experience
Authors:	陳煥霖;吳明賢;張文熊;施壽全;紀鑫;白明忠 CHEN, HUAN-LIN;WU, MING-SHIANG;CHANG, WEN-HSIUNG;SHIH, SHOU-CHUAN;CHI, HSIN;BAIR, MING-JONG
Contributors:	內科部
Keywords:	abdominal tuberculosis;extrapulmonary tuberculosis;gastrointestinal tuberculosis;tuberculosis;tuberculous peritonitis
Date:	2009
Issue Date:	2011-05-25 14:55:19 (UTC+8)
Abstract:	Background/Purpose: Abdominal tuberculosis (TB) is a rare manifestation of extrapulmonary TB. This disease entity can be overlooked, and its early diagnosis is difficult because of its variable manifestations and lack of specific symptoms . Methods: The clinical and diagnostic features, treatment, and outcome of patients with abdominal TB at a major hospital in southeastern Taiwan from January 1987 to December 2006 were investigated. Results: Twenty-one patients with abdominal TB identified during the 20-year period were included. A predominance of male (13/21, 61 .9%) and Taiwanese aborigine (15/21, 71.4%) patients was noted. Middle- aged (30-50 years) patients with alcoholic liver cirrhosis had the highest risk. Common presenting features included abdominal pain (18/21, 85.7%), fever (16/21, 76.2%) , ascites (13/21, 61.9%), and weight loss (12/21, 57. 3%). The mean time to reach a diagnosis was 48 +/- 10 days. Tuberculous peritonitis was noted in 11 patients, with a high correlation with liver cirrhosis (p = 0.0237, Fishees exact test). The other patients were diagnosed with TB of the gastrointestinal tract (n=6), urinary tract (n=2) , and pelvis (n=2). Abdominal sonography and abdominal computed tomography were helpful for diagnosis, by revealing ascites and thickening of the peritoneum. Pulmonary involvement was noted in 11 patients. Most of the patients (16/21, 76.2%) improved with anti-tuberculosis therapy, and five patients died from sepsis and respiratory failure. Conclusion: Abdominal TB is a rare manifestation of extrapulmonary, TB, even in southeastern Taiwan where TB is prevalent. Delay in diagnosis is common and abdominal TB; should be included in the differential diagnosis of middle-aged aborigine men with alcoholic liver cirrhosis and peritonitis.
Relation:	JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION v.108 n.3 pp.195-201
Appears in Collections:	[附設醫院內科部] 期刊論文

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