Abdominal tuberculosis revisited.

Four patients with abdominal tuberculosis (ATB) managed in the University Department of Medicine, Singapore General Hospital, are presented to highlight problems encountered in the diagnosis of this condition. Three patients had intestinal tuberculosis, one of whom had peritoneal involvement and another had possible hepatic disease. The fourth patient presented with peritoneal disease alone. Ages at presentation ranged from 25 years to 71 years. There were three females and one male. Two patients presented with symptoms of chronic illness for 10 months before the disease was diagnosed. Two other patients had acute presentations. Fever, abdominal pain, vomiting and diarrhoea were the main symptoms encountered. Three patients had abdominal masses at diagnosis. Radiological investigations were the most useful diagnostic aid. Bacteriological confirmation was made in only one patient. Histology helped in the diagnosis in two others. Recent literature on this condition was reviewed and the possible role of impaired immunity in the pathogenesis of this condition was discussed.