EN
TÜRKÇE
Poster - 353
Pediatric abdominal tuberculosis in an endemic region: clinical presentation, management strategies and outcomes
Fatima Zahra 1, Rashida Abbas Fakhruddin Lacewala 1, Javeria Javed 2, Muhammad Osama Khan 2, Muhammad Aqil Soomro 2, Saqib Qazi 2, Saleem Islam 2
1 Medical College, Aga Khan University, Karachi, Pakistan
2 Section of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
Purpose
Tuberculosis (TB) remains a major global health burden, particularly in LMICs. Abdominal tuberculosis (AbTB), an extrapulmonary form of TB, presents diagnostic challenges due to nonspecific symptoms that overlap with other gastrointestinal conditions. This study aimed to describe the clinical presentation, diagnostic evaluation, and treatment outcomes of pediatric AbTB in a tertiary care setting.
Methods
We conducted a retrospective review of children under 18 years diagnosed with AbTB at tertiary care hospital in Pakistan from January 2012 to December 2022. Data collected included demographics, clinical features, diagnostic modalities, treatment regimens and outcomes. Patients were categorized into medical and surgical groups based on their management. Descriptive statistics were used for baseline characteristics and associations were assessed using statistical tests where appropriate. A p value of less than 0.05 was considered statistically significant.
Results
A total of 67 children were included, out of which 21(31.3%) were males. The median age and weight were 14 years (IQR: 11–16 years), and 28 kg (IQR: 18.5–35 kg) respectively. Abdominal pain, fever, altered bowel habits, and weight loss were the most frequent presenting symptoms. Abdominal CT was the most common imaging modality used (75%), followed by ultrasound (57%) and x-ray (25%). All patients received standard anti-TB therapy (ATT), and 14.2% of them required second-line treatment. Surgical intervention was required in 22% of cases. Mortality was higher in surgical group but not statistically significant (13% vs 3.9%, p=0.2). Readmission was significantly more frequent among surgical patients than among medical patients (19% vs 2%, p<0.05).
Conclusion
Pediatric AbTB often presents with nonspecific symptoms, causing delays in diagnosis and treatment. While most patients respond to medical therapy, not surprisingly those requiring surgery experience higher morbidity. Strengthening early diagnostic and referral pathways may reduce the need for surgery and improve outcomes.