Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience


  • Hana Arbab The Indus Hospital, Karachi
  • Nawal Khan
  • Farhana Amanullah
  • Lubna Samad




Abdominal Tuberculosis, ATB, TB


Background: Although uncommon in children, abdominal tuberculosis (ATB) can be a life-threatening condition with a subset requiring emergency surgical intervention.  This study aims to determine the presentation, surgical procedures performed, and outcomes in children affected by abdominal tuberculosis.

Methods: A retrospective chart review of all children undergoing surgical intervention for ATB from July 2007 to December 2018 was conducted. Data were analyzed using SPSS version 22.

Results: Of 340 children with a diagnosis of ATB seen at the Indus Hospital’s TB clinic, 14 (4%) underwent laparotomy. Females were affected more commonly (57%), with a mean age at presentation of 11 years (range 8-14). Nine children required laparotomy for documented perforation, while 5 had an intestinal obstruction. Most children (n=10) had an established diagnosis of ATB before the surgical intervention; 2 children had completed 6–9 months anti-tuberculous treatment (ATT) courses, while 8 children had been on ATT for a mean period of 2.5 months at the time of developing acute surgical symptoms.  Diversion ileostomy was made in 64%.  Postoperative complications included sepsis (n=4), wound infection (n=3), abdominal collection (n=2), enterocutaneous fistula (n=2), and abdominal wound dehiscence requiring formal closure (n=2). There were 4 mortalities (29%); 10 patients were discharged after a median in-hospital stay of 12 days (range 6-35) of which 6 with ileostomies underwent reversal after completion of the ATT course.

Conclusion: ATB has high morbidity and mortality. Perforation and obstruction can occur during or after the completion of ATT.  Management requires early recognition and surgical intervention as indicated.


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Tuberculosis. Available from: http://www.who.int/en/news-room/fact-sheets/detail/tuberculosis.

Sharma MP, Bhatia V. Abdominal tuberculosis. Ind J Med Res. 2004; 120:305-15.

Pakistan: Tuberculosis. Available from: http://www.emro.who.int/pak/programmes/stop-tuberculosis.html.

Aston N. Abdominal tuberculosis. World J Surg. 1997; 21:492-9.

Chandir S, Hussain H, Salahuddin N, Amir M, Ali F, Lotia I, et al. Extrapulmonary tuberculosis: a retrospective review of 194 cases at a tertiary care hospital in Karachi, Pakistan. J Pak Med Assoc. 2010; 60:105-9.

Rajput MJ, Memon AS, Rani S, Memon AH. Clinicopathological profile and surgical outcomes of patients suffering from gastrointestinal tuberculosis undergoing laparotomy. J Liaquat Uni Med Health Sci. 2005; 5:119-21.

Khan IA, Khattak IU, Asif S, Nasir M, Zia ur R. Abdominal tuberculosis an experience at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad. 2008; 20:115-8.

Arif AU, Shah LA, Asadullah, Sadiq M. The frequency and management of intestinal tuberculosis; a hospital based study. J Postgrad Med Instit. 2008; 22:152-6.

Ahmed M, Mughal MA, Mengal MA. Varied intestinal tuberculosis: an experience at Sandeman Hospital, Quetta. J Coll Phys Surg Pak. 2000; 10:246-8.

Basu S, Ganguly S, Chandra PK, Basu S. Clinical profile and outcome of abdominal tuberculosis in Indian children. Singapore Med J. 2007; 48:900-5.

Tinsa F, Essaddam L, Fitouri Z, Brini I, Douira W, Ben Becher S, et al. Abdominal tuberculosis in children. J Pediatr Gastroenterol Nutr. 2010; 50:634-8.

Kılıç Ö, Somer A, Hançerli Törün S, Keser Emiroğlu M, Salman N, Salman T, et al. Assessment of 35 children with abdominal tuberculosis. Turk J Gastroenterol. 2015; 26:128-32.

Gürkan F, Özateş M, Boşnak M, Dikici B, Boşnak V. Tuberculous peritonitis in 11 children: Clinical features and diagnostic approach. Pediatr Int. 1999; 41:510-3.

Lin YS, Huang YC, Lin TY. Abdominal tuberculosis in children: a diagnostic challenge. J Microbiol Immunol Infect. 2010; 43:188-93.

Codlin AJ, Khawaja S, Chen Z, Rahbar MH, Qadeer E, Ara I, et al. Gender differences in tuberculosis notification in Pakistan. Am J Trop Med Hygiene. 2011; 85:514-7.

Ozbey H, Tireli GA, Salman T. Abdominal tuberculosis in children. Eur J Pediatr Surg. 2003; 13:116-9.

Lal V, Deolekar S, Mahapatra B, Narayan P, Sheikh T. Study of gastrointestinal tuberculosis and role of surgery in its management in Navi Mumbai: analysis of 50 cases. Ind J Basic Appl Med Res. 2014; 4:363-74.

Jaskani S, Mehmood N, Khan NM, Khan HD, Anwar I. Surgical management of acute presentation and outcome of patients with complicated abdominal tuberculosis. J Rawalpindi Med Coll. 2016; 20:108-12.

Malik KA, Waheed I. Frequency of intestinal tuberculosis in cases of intestinal obstruction. J Liaquat Uni Med Health Sci. 2006; 5:119-21.

Pathak P, Sahu SK, Agrawal S. Clinico-pathological profile and surgical outcome of patients of gastrointestinal tuberculosis undergoing laparotomy. Chirurgia. 2016; 111:487-92.

Keshri A, Kumar A, Prakash S, Singh KP. Koch's abdomen- management of surgical complications and outcomes at a remote hill area tertiary care center. Int Surg J. 2019; 6:1514-9.

Mirza B, Ijaz L, Saleem M, Sheikh A. Surgical aspects of intestinal tuberculosis in children: Our experience. Afr J Paediatr Surg. 2011; 8:185-9.

Pattanayak S, Behuria S. Is abdominal tuberculosis a surgical problem? Ann R Coll Surg Engl. 2015; 97:414-9.

Akbar M, Fakhar ul I, Haider IZ, Naveed D, Akbar I, Khattak I, et al. Surgical management of tuberculous small bowel obstruction. J Ayub Med Coll Abbottabad. 2010; 22:171-5.

Iqbal T, Khan A, Iqbal A, Tahir F. Obstruction due to intestinal tuberculosis: Stricturoplasty versus resection anastomosis. Pak J Surg. 2008; 24:177-81.

Charokar K, Garg N, Jain AK. Surgical management of abdominal tuberculosis:a retrospective study from Central India. Int Surg J. 2016; 3:9



How to Cite

Arbab H, Khan N, Amanullah F, Samad L. Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience. J Pediatr Adolesc Surg [Internet]. 2021Feb.15 [cited 2022Aug.7];1(2):70-3. Available from: http://jpedas.org/ojs/index.php/jpedas/article/view/jpas-20
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