abdominal tuberculosis

Question 1

sites which is affected by tb?

Answer 1

peritoneum, small intestine, lymph nodes and liver.

Question 2

route to infect peritoneum?

Answer 2

raptured lymph node, or by hematogenous route.

Question 3

symptoms?

Answer 3

abdominal pain(right lower quadrant) cramping and dull, low grade fever, sweating, anorexia, weight loss, ascites. symptoms mimic the cirrhosis

Question 4

what leads to obstruction of small intestine?

Answer 4

fibroplastic bands and adhesion between intestinal coil

Question 5

what is doughy abdomen?

Answer 5

on palpation abdomen is rigid

Question 6

investigation?

Answer 6

chest xray is abnormal in more than 70%
ascites fluid is exudate protein >2.5g/dl, ldh >90 wbcs >500
ascitic fluid pcr is fastest way to detect organism
fluid culture
laparoscopic peritoneal biopsy to check nodules and granulomas

Question 7

types of intestinal tuberculosis?

Answer 7

secondary is the most common and it is the most common complications of pulmonary tuberculosis
primary tuberculosis occur due to the ingestion of bovine containing milk

Question 8

pathological events?

Answer 8

may be ulcerative 60% or hypertrophic 10%
in ulcerative long axis of ulcer is perpendicular to long axis of GI segment therefore more prone to stricture formation
hypertrophic more common in ileocecal region consisting of scarring and fibrosis

Question 9

d/d of abdominal tuberculosis?

Answer 9

crohn's disease
intestinal amebiasis
intestinal lymphoma
carcinoma of colon
ileocecal tuberculosis

Question 10

management?

Answer 10

rest
ATT for 1 year
surgery if intestinal obstruction and perforation occur