Abdominal tuberculosis: a surgical perplexity

Ketan R. Vagholkar, Shantanu Chandrashekhar, Suvarna Vagholkar


Abdominal tuberculosis is one of the most challenging forms of extra pulmonary tuberculosis. The diagnosis of the disease itself poses the greatest challenge due to the variability of presentation. Clinical presentations in various forms with conflicting results on a multitude of haematological, immunological and radiological tests causes a lot of confusion in interpreting and correlating the symptoms to arrive at a diagnosis. This adds to the perplexity in surgical management of this complex disease especially in an era where AIDS has added to the problems. Having arrived at a diagnosis, chemotherapy is the mainstay of treatment. Surgery is indicated when the response to medical therapy is poor or complications supervene. Deciding the optimum procedure is again a major issue. Understanding the pathophysiology therefore is pivotal in making a value decision. The article briefly outlines the approach to this surgical perplexity.


Abdominal tuberculosis, Pathology, Investigations, Diagnosis, Surgical, Complications, Treatment

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Das P, Shukla HS. Clinical diagnosis of abdominal tuberculosis. Br J Surg. 1976 Dec;63(12):941-6.

Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol. 1977 Apr;67(4):324-37.

Tandon RK, Sarin SK, Bose SL, Berry M, Tandon BN. A clinico-radiological reappraisal of intestinal tuberculosis-changing profile?. Gastroenterologia Japonica. 1986 Feb 1;21(1):17-22.

Al-Hadeedi S, Walia HS, al-Sayer HM. Abdominal tuberculosis. Can J Surg. 1990 Jun;33(3):233-7.

al-Quorain AA, Facharzt, Satti MB, al-Freihi HM, al-Gindan YM, al-Awad N. Abdominal tuberculosis in Saudi Arabia: a clinicopathological study of 65 cases. Am J Gastroenterol. 1993 Jan;88(1):75-9.

El Masri SH, Boulos P, Malick MO. Abdominal tuberculosis in Sudanese patients. East Afr Med J. 1977 Jun; 54(6):319-26.

Addison NV. Abdominal tuberculosis-a disease revived. Ann R Coll Surg Engl. 1983 Mar;65(2):105-11.

Jayanthi V, Probert CS, Sher KS, Wicks AC, Mayberry JF. The renaissance of abdominal tuberculosis. Dig Dis. 1993;11(1):36-44.

Probert CS, Jayanthi V, Wicks AC, Carr-Locke DL, Garner P, Mayberry JF. Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut. 1992 Aug;33(8):1085-8.

Findlay JM, Addison NV, Stevenson DK, Mirza ZA. Tuberculosis of the gastrointestinal tract in Bradford, 1967-77. J R Soc Med. 1979 Aug;72(8):587-90.

Dineeen P, Homan WP, Grafe WR. Tuberculous peritonitis: 43 years' expereince in diagnosis and treatment. Annals of surgery. 1976 Dec;184(6):717.

Vagholkar K. Abdominal Tuberculosis: A Surgical Enigma. MOJ Surg. 2016;3(2):00043.

Ko CY, Schmit PJ, Petrie B, Thompson JE. Abdominal tuberculosis: the surgical perspective. Am Surg. 1996 Oct;62(10):865-8.

Fee MJ, Oo MM, Gabayan AE, Radin DR, Barnes PF. Abdominal tuberculosis in patients infected with the human immunodeficiency virus. Clinical infectious diseases. 1995 Apr 1;20(4):938-44.

Shah P, Ramakantan R. Role of vasculitis in the natural history of abdominal tuberculosis-evaluation by mesenteric angiography. Ind J gastroenterol. 1991 Oct;10(4):127-30.

Katariya RN, Sood S, Rao PG, Rao PL. Stricture‐plasty for tubercular strictures of the gastro‐intestinal tract. Bri J Surge. 1977 Jul;64(7):496-8.

Underwood MJ, Thompson MM, Sayers RD, Hall AW. Presentation of abdominal tuberculosis to general surgeons. Br J Surg. 1992 Oct;79(10):1077-9.

Pattanayak S, Behuna S. Is abdominal tuberculosis a surgical problem? Ann R Coll Surg Engl. 2015;97:414-9.

Wani MU, Parvez M, Kumar SH, Naikoo GM, Jan M, Wani HA. Study of Surgical Emergencies of Tubercular Abdomen in Developing Countries. Ind J Surg. 2015;77:182-5.

Pujari BD. Modified surgical procedures in intestinal tuberculosis. Br J Surg. 1979;66:180-1.

Vagholkar KR. Abdominal Tuberculosis. Bombay Hospital J.1995;37(3):441-5.