BIOPSY-PROVED ABDOMINAL TUBERCULOSIS IN TABRIZ

Background – Because of the increasing incidence of tuberculosis, the growing number of extrapulmonary cases, and paucity of information about abdominal tuberculosis we performed this study on biopsy-proved abdominal tuberculosis cases in the past 15 years in Tabriz. Methods – The medical records of all tuberculosis patients admitted to Tabriz Tuberculosis Center between the years 1984 and 1999 were reviewed and biopsy-proved abdominal cases were selected for a descriptive cross-sectional study. Results – Among 4,693 new cases of tuberculosis in a 15-year period, abdominal tuberculosis was the 5th common type of TB in Tabriz and 77 biopsy-proved cases were selected for the study. Eighty-seven percent of the patients were females. The mean age of the patients was 34 ± 16 years (age range: 13 – 75 years). The peak incidence was seen in the second, third, and fourth decades of life (28%, 27%, and 23%, respectively). The most common complaints were abdominal pain (57%), abdominal swelling (16%), and infertility (9%). The sites of involvement were peritoneum (56%), peritoneum plus genitalia (6.5%), mesenteric lymph nodes (6.5%), peritoneum plus abdominal lymph nodes (2.6%), cecum (2.6%), esophagus (2.6%), gallbladder (2.6%) and a combination of intraabdominal or intra/extraabdominal organs. Before 1991, the majority of patients were treated with isoniazid (INH) + rifampicin (RMP) +ethambutol (ETB) or streptomycin (SM); since then, the treatment has changed to the standard 6-month regimen with 4 drugs. Overall, treatment regimens were INH + RMP + ETB (48%), INH + RMP + ETB + PZA (44%), and INH + RMP + SM (8%). Conclusion – In this study, abdominal tuberculosis was more common in females than males and 7% of our patients were referred due to infertility. Applying more stringent criteria for diagnosis of abdominal TB and availability of noninvasive or less-invasive diagnostic methods may change our results in the future.