PRIMARY MULTIDRUG RESISTANCE ABDOMINAL TUBERCULOSIS
Dr. Arjun Sharma*, Dr. Sandeep Mahajan, Dr. Shagun and Dr. Shaheed Arman Khondekar
Tuberculosis has been a major cause of morbidity and mortality around the world. Abdominal Tuberculosis constitute 3%-5% of extra-pulmonary tuberculosis [EPTB] which accounts for approximately 20% of all cases with TB in immunocompetent individuals. The preferred site of involvement by TB is the ileocaecal region because of abundance of lymphoid tissue, relative physiologic stasis, and minimal digestive activity which permits greater contact time of acid-fast bacilli [AFB] with the mucosal surface of the ileocecum. Other sites of involvement that are common include the colon [where the segmental decrease of frequency occurs from the ascending colon to the rectum], jejunum, stomach, duodenum and oesophagus. Abdominal tuberculosis shows some nonspecific features of the disease which causes delay in the diagnosis and development of complications. This condition therefore is known as a great mimicker of other abdominal pathology. The treatment for multidrug resistance tuberculosis is complicated as most of the second line anti TB drugs are weak and toxic. Because of this reason MDR treatment generally takes 18-24 months. Patients of abdominal tuberculosis suffers from various sequelae such as intestinal obstruction, perforation, fistulas and fibrosis that increases morbidity if left untreated.
Keywords: Abdominal tuberculosis, MDR-TB, Ileocecum.
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