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H M al-Sayer

Publications and source records attributed to H M al-Sayer.

2 recordsLinked to original sources

Unusual presentations of abdominal tuberculosis.

OBJECTIVE: To review unusual presenting features and diagnostic difficulties of abdominal tuberculosis in an endemic region. DESIGN: Retrospective clinical study from 1984 to 1989, illustrated by case reports. SETTING: A single hospital in Kuwait. PATIENTS: Fifty patients with abdominal tuberculosis established by the standard histologic and bacteriologic demonstration of acid-fast bacilli or tuberculous granulomas. MAIN OUTCOME MEASURES: Site of disease and unusual features at presentation. RESULTS: Tubercular lesions are most commonly seen in the ileocecal region. They are also common in the ileum but are less common in the appendix and jejunum. Involvement of the ascending colon, rectum and upper gastrointestinal tract is rare. Abdominal tuberculosis presents in many ways depending on the degrees of ulceration, fibrous healing, infection and caseating abscess formation. CONCLUSIONS: Abdominal tuberculosis should be considered in immigrants from regions where this disease is endemic who present with abdominal signs and symptoms. Imaging studies, endoscopy and laparoscopy may preclude laparotomy for the diagnosis of abdominal tuberculosis. Antituberculosis chemotherapy is the mainstay of treatment.

Abdomen↗

Abdominal tuberculosis.

Forty-two cases of abdominal tuberculosis seen between June 1984 and June 1988 at Amiri Hospital in Kuwait were reviewed retrospectively. The clinical diagnosis was correct in only 35%. Nine patients presented as an emergency, but in none was a diagnosis of tuberculosis considered. Abdominal pain and tenderness were the commonest clinical findings; "doughy abdomen" and a mass in right iliac fossa were uncommon. Thus, symptoms were vague, signs nonspecific and investigations nonpathognomonic. In spite of this, abdominal tuberculosis should be considered in any patient who has obscure abdominal symptoms, weight loss and lethargy. Laparoscopy and colonoscopy with biopsy for histologic and bacteriologic study led to a definitive diagnosis in 66% of cases, obviating the need for exploratory laparotomy in many. Histologic examination was the surest way to establish the diagnosis.

Abdomen↗