Abdominal Tuberculosis in Children

Abstract

Objective To provide an insight into the presentation, diagnosis, and management of gastrointestinal tuberculosis in children.

Methods We reviewed the medical records of children who were diagnosed with gastrointestinal tuberculosis, between October 2013 and October 2023. The analysis was performed using descriptive statistics.

Results During the study period, 11 of 76 tuberculosis pediatric patients (14.5%) were diagnosed with gastrointestinal tuberculosis. Six of 11 patients (54.5%) were female. The median age of the patients was 60 months (51–205 months). Eight of 11 patients had intra-abdominal lymph node involvement, 3 of 11 patients had intestinal tuberculosis, and 2 of 11 patients had also active pulmonary tuberculosis. Multiple intra-abdominal areas were involved in six patients. Mean duration of symptoms before admission was 60 days (5–180 days). The most common symptoms were abdominal pain (63.7%), weight loss (63.7%), and weakness/fatigue (54.5%). Acid-fast bacilli and tuberculosis polymerase chain reaction were positive in only two patients. Tuberculosis culture positivity was detected in two patients, both of them showed Mycobacterium bovis growth. Necrotizing granulomatous inflammation was the most frequently observed histopathological finding. Anemia was detected in six patients. There was elevated erythrocyte sedimentation rate in eight patients and elevated C-reactive protein in six patients. In one patient, recurrent obstruction symptoms developed due to stenosis of terminal ileum. Clinical cure was achieved with supportive treatment.

Conclusion Diagnosis of gastrointestinal tuberculosis is very difficult due to nonspecific clinical and radiological features. Microbiological confirmation of the disease is often challenging. Making a definitive diagnosis requires reliance on strong clinical suspicion, imaging and histopathological findings, microbiological tests, and/or response to treatment.

Keywords

Mycobacterium tuberculosis - tuberculosis - extrapulmonary - abdominal - children

Availability of Data and Material

The authors confirm that the data supporting the findings of this study are available within the article.

Code Availability

All source codes are available within the article [and/or] its supplementary materials.

Authors' Contributions

M.E.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and drafting the article and revising it critically for important intellectual content.

G.A.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

M.K.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

S.K.T.O.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

H.T.D.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

M.Ö.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

Z.E.Ç.: substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and revising it critically for important intellectual content.

We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript.

Ethics Approval

The study protocols were approved by Selçuk University Faculty of Medicine ethics committee (2023/568).

Consent to Participate

We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

Consent for Publication

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Manuscript is not under publication or consideration for publication elsewhere.

Publication History

Received: 26 March 2024

Accepted: 16 October 2024

Article published online:
29 November 2024

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