EXTRA PULMONARY CHILDHOOD TUBERCULOSIS

Aim: In Egypt T.B lymphadenitis and abdominal T.B are relatively common in children and sometimes difficult to diagnose. Also, complete cure may be difficult to achieve. The aim of this study is to evaluate the accuracy of the diagnostic tools used for early diagnosis of the disease and the role of the pediatric surgeon in its management. Methods: Ninety two of clinically suspected extrapulmonary T.B (59 females, 33 males) attended at Assiut University Hospitals were included in the study. Their ages varied from 6 months to 15 years. They were 58 cases of T.B lymphadenitis, 30 cases of abdominal T.B and 4 T.B of skin. Results: Fine needle aspiration (FNA) biopsy from T.B lymphadenitis was diagnostic in 90% of cases. Surgical excision of tuberculous lymph nodes larger than 2 cm or T.B ulcer, after 2 months, treatment by antituberculous drugs, is important as it removes the pathological lesion. Laparoscopy and laparoscopic biopsy are the most useful diagnostic tools in abdominal T.B in properly selected cases. Conclusion: Extrapulmonary tuberculosis in children is still not infrequent. FNA biopsy of lymph nodes proved to be successful in establishing diagnosis in the majority of cases and in endemic areas should replace and save the patients from excisional biopsy. Excision of large tuberculous lymph nodes not, responding enough after 2 months of anti T.B treatment, is recommended. Diagnostic laparoscopy, in properly, selected cases, is a safe procedure and can confirm the diagnosis