Published online Aug 27, 2017. doi: 10.4240/wjgs.v9.i8.174
Peer-review started: December 25, 2016
First decision: January 16, 2017
Revised: May 22, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: August 27, 2017
It is important that surgeons are familiar with the various manifestations of tuberculosis (TB). Although TB has been declining in incidence in the developed world, it remains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.
Core tip: It is important to bear in mind the non-specific manifestations of abdominal tuberculosis. There is no gold standard for the diagnosis and high clinical suspicion is required. Diagnostic laparoscopy is increasingly useful but joint decision making with physician familiar with anti-tuberculous therapy is important. Surgery is reserved for abdominal complications.