The Prevalence and Clinical Presentation of Abdominal Tuberculosis in Patients With Acute Surgical Abdomen: A Prospective Observational Study

Background and objective The diagnosis of abdominal tuberculosis (ATB) poses significant difficulty in the context of acute abdomen cases, especially in regions where it is endemic. This study aimed to determine the frequency and clinical manifestations of ATB among adults with an acute surgical abdomen at a tertiary care center in Ranchi, India, focusing on the means of arriving at the diagnosis and subsequent treatment results. Methods Our study involved 60 patients with acute abdominal symptoms and was conducted during the year 2023-2024 at the Rajendra Institute of Medical Sciences, Ranchi. We collected demographic data along with imaging studies such as X-ray, ultrasound, CT scan, acid-fast bacilli (AFB) smear, cartridge-based nucleic acid amplification test (CBNAAT), intraoperative findings, histopathological examination (HPE), and symptomatology to perform relevant and timely diagnosis. The association between clinical symptoms of the patients and ATB was assessed using the chi-square test. Results The confirmation rate of ATB was five (8.3%) among the patients. A significant association was observed with fever and weight loss (p<0.01), although all patients did report some degree of abdominal pain. HPE showed high accuracy with 90% sensitivity and 95% specificity. For CT imaging, sensitivity and specificity were reported at 70% and 85%, respectively, while ultrasound sensitivity lagged at approximately 60%. Anti-tuberculosis therapy (ATT) had demonstrable benefits for all ATB patients. Common intraoperative findings involved lymphadenopathy along with ascites. Conclusions The data indicate that ATB was present in five (8.3%) cases, manifesting as acute abdomen presenting surgically; we identified weight loss and fever as main symptoms that contributed to our diagnostic approach, leading us to diagnose it more effectively than would otherwise be possible in unexplained abdominal pain cases. HPE-based imaging tests performed alongside appropriate medications showed excellent results in endemic areas.