Confronting the Challenge of Abdominal Tuberculosis

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS MEDIA RELEASE

Confronting the Challenge of Abdominal Tuberculosis

Friday 10 May, 2013

Abdominal tuberculosis (ATB) continues to pose a significant diagnostic, management and resource challenge, delegates to the 82nd Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons have been told.

With an increasing number of tuberculosis cases being reported in Australia, Dr Preetjote Gill, a Sydney based Surgical Trainee, undertook a study involving all diagnosed cases at the Royal North Shore tertiary hospital campus of Sydney University.

“All cases are entered prospectively into a central registry,” Dr Gill said. “This enabled us to identify and retrospectively review all cases of ATB encountered between September 1991 and November 2011.”

“Of the 841 cases of tuberculosis identified, 20 were abdominal (2.4%). The median age at presentation was 34 years (range 22-79) and 55% were female. None of the patients were born in Australia, and 11 patients were of South Asian origin.

“The most common symptom was abdominal pain (65%) and diagnosis was based primarily on histology (90% sensitivity). Eleven of the patients required laparoscopy or laparotomy. Forty per cent of cases involved the peritoneum and disease was also seen in solid organs (liver, spleen, pancreas, adrenal gland) and bowel (oesophagus, small bowel, colon).”

Dr Gill told delegates that this local experience, in a low endemic area tertiary hospital, echoes that reported in other developed countries with a high immigrant population.

“The presentation of ATB varies greatly, necessitating a high degree of suspicion within the context of abdominal symptoms in high-risk groups.

“The role of the surgeon is indispensable in both the diagnosis and management of ATB related complications. Surgeons in Australia should remain mindful of the possibility of a diagnosis of ATB in an age of increasing worldwide incidence,” he said.

Approximately 1200 surgeons from New Zealand, Australia and around the world are attending the ASC, which runs from 6 to 10 May and is being held at Auckland’s Skycity/Crowne Plaza Convention Centre.

ENDS

© Scoop Media