Abdominal Tuberculosis: An Interdisciplinary Approach to Diagnosis, Treatment, and Patient Care-An Updated Review

Vollständiger Abstract

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Background: Abdominal tuberculosis is an important extrapulmonary manifestation of Mycobacterium tuberculosis infection and remains a diagnostic challenge because of its variable, nonspecific, and often indolent presentation. Its clinical and pathological similarities with other gastrointestinal diseases may result in delayed or inappropriate diagnosis. Aim: To provide a comprehensive overview of the etiology, epidemiology, pathophysiology, histopathology, clinical presentation, diagnostic evaluation, differential diagnosis, and contemporary management of abdominal tuberculosis. Methods: This narrative review synthesized established clinical and diagnostic information concerning abdominal tuberculosis, focusing on disease mechanisms, laboratory and microbiological investigations, imaging modalities, endoscopic and laparoscopic assessment, therapeutic approaches, and differentiation from major clinical mimics, particularly Crohn's disease. Results: Abdominal tuberculosis may involve the intestine, peritoneum, lymph nodes, and solid abdominal organs. Common manifestations include abdominal pain, fever, anorexia, weight loss, altered bowel habits, ascites, and intestinal obstruction. Laboratory findings are generally nonspecific. CT is central to evaluating disease distribution, while histopathology, culture, and molecular testing contribute to diagnostic confirmation. The paucibacillary nature of disease limits the sensitivity of conventional microbiological tests. Standard treatment generally consists of a six-month multidrug anti-tuberculosis regimen, with endoscopic or surgical intervention reserved for selected complications. Conclusion: Early recognition requires a high index of suspicion and integration of clinical, radiological, microbiological, and histopathological findings.