What remains to surgeons in the management of abdominal tuberculosis? A 10 years experience in an endemic area.

Autor:	Noomene R; Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia; Faculty of Medicine, Tunis, Tunisia. Electronic address: rabiinoomene@yahoo.fr., Ouakaa A; Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia; Faculty of Medicine, Tunis, Tunisia., Jouini R; Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia; Faculty of Medicine, Tunis, Tunisia., Maamer AB; Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia; Faculty of Medicine, Tunis, Tunisia., Cherif A; Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia; Faculty of Medicine, Tunis, Tunisia.
Jazyk:	angličtina
Zdroj:	The Indian journal of tuberculosis [Indian J Tuberc] 2017 Jul; Vol. 64 (3), pp. 167-172. Date of Electronic Publication: 2017 Feb 01.
DOI:	10.1016/j.ijtb.2017.01.003
Abstrakt:	Background: Tuberculosis (TB) is a common endemic disease in Tunisia. Abdominal location is rare. Early diagnosis of abdominal TB remains difficult due to its non-specific clinical presentations. The aim of our study is to highlight the characteristics of the different presentations, to characterize tools contributing to a positive preoperative diagnosis, and finally to assess the role of surgery in the management of this entity. Materials and Methods: A retrospective review from 2005 to 2015 identified 90 cases of confirmed abdominal TB managed in the Department of General Surgery of the Habib Thameur Hospital. The diagnosis was established by histopathology examination for all cases. This study was approved by the ethical committee. Results: The mean age of the patient was 44.13 years with a sex ratio (M/F) of 0.34. We collected 56 cases of peritoneal TB, 12 cases of abdominal lymph node TB, 10 cases of intestinal TB, four cases of hepatic TB, and two cases of gallbladder's TB. For six patients, an association of many localizations was noted. The diagnosis was suspected on clinical, biological, and morphological arguments, but the confirmation was always made by surgical exploration and pathological examination of removed specimens. Surgical management was urgent in complicated cases (13.3%). Laparoscopy was performed in 71 cases (78.9%). Laparoscopic features of peritoneal TB were specific and always confirmed by histological examination. Conclusion: Despite the wide range of examination available for the preoperative exploration of abdominal TB, diagnosis is usually late and difficult. TB is a medical condition. However, surgical exploration is frequently needed in the management. (Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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