PATTERN AND PRESENTATION OF ABDOMINAL TUBERCULOSIS IN PORT SUDAN TEACHING HOSPITAL

Tuberculosis is a multisystemic, infectious, necrotizing, granulomatous disease, caused by mycobacterium bacilli, mainly mycobacterium tuberculosis, it represent a common community problem in Red sea state - eastern Sudan. The disease mainly affect the lung, but any tissue can be involved. The incidence of extra-pulmonary tuberculosis in Red sea state – Sudan increased in last years and abdominal Tuberculosis represent the commonest pattern of extra-pulmonary tuberculosis in Red sea state, it represent a real problem in this area. So this descriptive, interventional study done in port Sudan teaching hospital from February 2014 to June 2015 to know the pattern and presentation of abdominal tuberculosis, making local guide for diagnosis to minimize both under or over diagnosis. Thirty eight patient were enrolled in this study 57% male and 43 % female. Presenting symptom were abdominal pain in 57%, fever 50% , wt loss 43% , abdominal distention 21 %, diarrhea 7 %, vomiting 7%, half of patient showed respiratory symptom and just 14 % had past history of pulmonary tuberculosis. Leucopenia appear in 36% of patient and leucocytosis in 36%. Features of anaemia appear in 64% : 46% of them are normocytic normochromic anaemia while feature of iron deficiency anaemia appear in 18%, thrombocytosis 43% and thrombocytopenia 21%. Serum albumin low in 93% and liver enzyme normal in all patients. Mantoux test was positive in 57%, and negative in 43%. Abdominal U/S showed ascites in 36%, enlarged paraortic and mesenteric lymph nod in 29%, hepatospleenomegaly 14%, ileocecal mass 7%, peritoneal adhesion 7%, and psoas abscess 7%. Ascites was exudative in 93% of patients and transudative in 7%. CXR showed features of old PTB in 43% of patients. The pattern of TB presentation were ascites 36%, tabes mesentrica 29%, hepatosplenomegally 14%, intestinal obstruction 14%, and psoas abscess 7%.