Abdominal Tuberculosis Revisited

Tuberculosis is still a major problem in Asia. An increase in transglobal migration, ageing patients, socioeconomic deprivation and the acquired immune deficiency syndrome thwart efforts in disease control. With failure to control pulmonary tubercular disease, increasing numbers of cases of extra-pulmonary tuberculosis, such as abdominal tuberculosis, have been seen. Abdominal tuberculosis remains a diagnostic problem for surgeons. The signs and symptoms of abdominal tuberculosis are non-specific and there is no specific diagnostic test. Helpful tests would include analysis of ascitic fluid, polymerase chain reaction test, the findings at laparoscopy and endoscopy and histology. Primary treatment is medical with surgery reserved for those patients developing complications. For biliary tuberculosis, a combination of endoscopy, surgery and medical treatment is required.