Intraperitoneal Solid Organ Tuberculosis: Our 12-Year Experience

Tuberculosis is a worldwide health problem with a high prevalence in developing countries. The intraperitoneal solid organs such as the liver, spleen, and pancreas get affected in approximately 3.1% of patients with abdominal tuberculosis. In the majority of the cases, involvement occurs with disseminated disease. When these organs get involved in isolation, the diagnostic dilemma arises. This study aimed at presenting our 12 years of experience with tuberculosis of the liver, spleen, and pancreas. Out of 18 cases of disseminated tuberculosis, in 6 patients, histopathology and/or imaging studies were suggestive of the involvement of the liver, spleen, and pancreas with tuberculosis. Ten cases of isolated tuberculosis of solid organs with or without the involvement of other parts of the abdomen were identified. Descriptive statistics were used to summarize the data. There was a total of 16 cases with tuberculous involvement of the liver (n = 5), spleen (n = 6), and pancreas (n = 5). There were 12 male and 4 female patients with a male to female ratio of 3:1. Constitutional symptoms were present in half of the patients. Diagnostic laparoscopy and cholecystectomy were done on 1 patient with hepatic tuberculosis. Four patients (25%) died during initial admission only. Image-guided fine needle aspiration cytology and core needle biopsy help diagnose cases. Surgical intervention is indicated for undiagnosed cases with strong clinical suspicion, complications, and failed medical therapy. With standard antituberculous treatment, a complete cure can be achieved.