Abdominal Tuberculosis
https://doi.org/10.58838/2075-1230-2026-104-1-86-99
Abstract
The review analyzes 67 publications from international and Russian databases (PubMed, Scopus, elibrary), publications were selected by the following keywords: «abdominal tuberculosis», «pathogenesis», and «classification». This article presents contemporary data on the pathogenesis, classification and diagnosis of abdominal tuberculosis (ATB). It defines pathogenetic signs of peritonitis, enterocolitis, mesadenitis, splenitis, and hepatitis of tuberculous etiology. It presents classifications of ATB used worldwide. Based on them, a convenient clinical classification of ATB is offered including complications requiring surgical interventions.
About the Author
D. V. Plotkin
Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health; Pirogov Russian National Research Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Dmitry V. Plotkin, Doctor of Medical Sciences, Associate Professor, Surgeon, Leading Researcher of Research Clinical Department, Professor of General Surgery Department named after V.M. Buyanov, Surgery Institute
10 Stromynka St., Moscow, 107014;
Phone: + 7 (499) 268-28-10
References
1. Alperin M.M. Tuberkulez pishchevaritelnogo trakta (klinika, diagnostika, terapiya). [Tuberculosis of the gastrointestinal tract (clinical signs, diagnostics, therapy)]. Kiev, Medgiz Publ., 1950, 124 p.
2. Aryamkina O.L., Savonenkova L.N. Abdominal tuberculosis. Gastroenterologiya Sankt-Peterburga, 2008, no. 1, pp. 41-43. (In Russ.)
3. Barkanova O.N., Kaluzhenina A.A., Gagarina S.G., Popkova N.L. Questions about symptoms and diagnostics of spleen and liver tuberculosis. Lekarstvenny Vestnik, 2015, vol. 9, no. 2, pp. 43-47. (In Russ.)
4. Belledir E.N. Patogenez vnelegochnykh lokalizatsiy tuberkuleza. V kn. Vnelegochnyy tuberkulez. [Pathogenesis of extrapulmonary tuberculosis. In: Extrapulmonary Tuberculosis]. A.V. Vasiliev, eds., St. Petersburg, 2000, pp. 36-48.
5. Zhdanov D.A. Obschaya anatomiya i fiziologiya limfaticheskoy sistemy. [General anatomy and physiology of the lymphatic system]. Leningrad, Medgiz Publ., 1952, 336 p.
6. Kuznetsov N.A. The problem of medical classification. Sechenovskiy Vestnik, 2014, vol. 17, no. 3, pp. 14-21. (In Russ.)
7. Kulchavenya E.V. The impact of HIV infection on spectrum of extrapulmonary tuberculosis in Siberia and Far East. Journal Infectology, 2018, vol. 10, no. 4, pp. 89-95. (In Russ.) https://doi.org/10.22625/2072-6732-2018-10-4-89-95
8. Manucharyan D.A. Tuberkulez kishechnika. [Intestinal tuberculosis]. Moscow, Medgiz Publ., 1948, 178 p.
9. Panteleev A.M. Clinical understanding of pathogenesis of tuberculosis generalization in HIV patients. Tuberculosis and Lung Diseases, 2015, no. 2, pp. 26-31. (In Russ.) https://doi.org/10.21292/2075-1230-2015-0-2-26-31
10. Plotkin D.V., Vinogradova T.I., Reshetnikov M.N. et al. Features of the pathogenetic mechanisms of tuberculous peritonitis in an experiment. Bulletin of RSMU, 2021, no. 4, pp. 21-28. (In Russ.) https://doi.org/10.24075/vrgmu.2021.036
11. Plotkin D.V. Clinical and morphological forms of tuberculous peritonitis. Hirurg, 2022, no. 3-4, pp. 47-63. (In Russ.)
12. Plotkin D.V., Sinitsyn M.V., Reshetnikov M.N. et al. Tuberculous peritonitis: epidemiological, gender- and age-based characteristics in the city of Moscow. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 2, pp. 54-63. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-2-54-63
13. Reshetnikov M.N., Sterlikov S.A., Gafarov U.O., Plotkin D.V. Тuberculous enterocolitis as a reflection of immunosuppressive conditions. HIV Infection and Immunosuppressive Disorders, 2024, vol. 16, no. 4, pp. 90-98. (In Russ.) https://doi.org/10.22328/2077-9828-2024-16-4-90-98
14. Savonenkova L.N., Aryamkina O.L. Pathogenesis and morphogenesis of abdominal tuberculosis with involvement of the gastrointestinal tract. Nizhegorodskiy Meditsinskiy Journal, 2006, no. 2, pp. 89-94. (In Russ.)
15. Slogotskaya L.V., Bogorodskaya E.M., Shamuratova L.F., Sevastyanova T.A. Efficiency of screening for tuberculosis infection in children and adolescents in Moscow in 2019 based on the new procedure for using the intradermal test with tuberculosis recombinant allergen (ESAT-6/CFP-10). Tuberculosis and Lung Diseases, 2021, vol. 99, no. 1, pp. 15-25. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-1-15-25
16. Tuberkulez u vzroslykh. Klinicheskie rekomendatsii: [Tuberculosis in adults. Guidelines]. Moscow, Rossiyskoe Obschestvo Ftiziatrov Publ., 2024, 167 p.
17. Ftiziatriya. Natsionalnoye rukovodstvo. [Phthisiology. National Guidelines]. Perelman M.I., eds., Moscow, GEOTAR-Media Publ., 2007, 512 p.
18. Shtefko V.G. Voprosy patologicheskoy anatomii i kliniki limfogennykh faz tuberkuleznogo protsessa. [Issues of pathological anatomy and clinical signs of lymphogenous phases of tuberculosis]. Moscow, Leningrad, Biomedgiz Publ., 1937, 406 p.
19. Ahamed Z.R., Shah J., Agarwala R. et al. Controversies in classification of peritoneal tuberculosis and a proposal for clinico-radiological classification. Expert Rev. Anti-Infect. Ther., 2019, vol. 17, no. 8, pp. 547-555. https://doi.org/10.1080/14787210.2019.1642746
20. Allahyartorkaman M., Mirsaeidi M., Hamzehloo G. et al. Low diagnostic accuracy of Xpert MTB/RIF assay for extrapulmonary tuberculosis: a multicenter surveillance. Sci. Rep., 2019, vol. 9, no. 1, pp. 18515. https://doi.org/10.1038/s41598-019-55112-y
21. Alsayed S.S.R., Gunosewoyo H. Tuberculosis: pathogenesis, current treatment regimens and new drug targets. Int. J. Mol. Sci., 2023, vol. 24, no. 6, pp. 5202. https://doi.org/10.3390/ijms24065202
22. Alvarez S.Z. Hepatobiliary tuberculosis. J. Gastroenterol. Hepatol., 1998, vol. 13, no. 8, pp. 833-839. https://doi.org/10.1111/j.1440-1746.1998.tb00743.x.
23. Al-Zanbagi A.B, Shariff M.K. Gastrointestinal tuberculosis: A systematic review of epidemiology, presentation, diagnosis and treatment. Saudi J. Gastroenterol., 2021, vol. 27, no. 5, pp. 261-274. https://doi.org/10.4103/sjg.sjg_148_21
24. Amarapurkar D.N., Patel N.D., Amarapurkar A.D. Hepatobiliary tuberculosis in western India. Indian J. Pathol. Microbiol., 2008, vol. 51, no. 2, pp. 175-181. https://doi.org/10.4103/0377-4929.41644
25. Aslan B., Tüney D., Almoabid Z. et al. Tuberculous peritonitis mimicking carcinomatosis peritonei: CT findings and histopathologic correlation. Radiol. Case Rep., 2019, vol. 14, no. 12, pp. 1491-1494. https://doi.org/10.1016/j.radcr.2019.09.026
26. Barss L., Connors W.J.A., Fisher D. Chapter 7: Extrapulmonary tuberculosis. Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022, vol. 6, no. 1, pp. 87-108. https://doi.org/10.1080/24745332.2022.2036073
27. Baykan A.H., Sayiner H.S., Aydin E. et al. Extrapulmonary tuberculosıs: an old but resurgent problem. Insights Imaging, 2022, vol. 13, no. 1, pp. 39. https://doi.org10.1186/s13244-022-01172-0
28. Ben A.H., Koubaa M., Marrakchi C. et al. Extrapulmonary tuberculosis: update on the epidemiology, risk factors and preventon strategies. Int. J. Trop. Dis., 2018, no. 1, pp. 006.
29. Blair E.J., Pagel W. Fulminant tuberculous septicaemia and other atypical forms of abdominal tuberculosis. Tubercle, 1947, vol. 28, no. 6, pp. 115-123.
30. Boulland H. De la Tuberculose du péritoine et des plèvres chez l'adulte au point de vue du pronostic et du traitement. Paris, These Publ., 1885, 17 p.
31. Cherian J.J., Lobo I., Sukhlecha A. et al. Treatment outcome of extrapulmonary tuberculosis under Revised National Tuberculosis Control Programme. Indian J. Tuberc., 2017, vol. 64, no. 2, pp. 104-108. https://doi.org10.1016/j.ijtb.2016.11.028
32. Crohn B.B., Ginzburg L., Oppenheimer G.D. Regional ileitis: a pathologic and clinical entity. JAMA, 1932, no. 99, pp. 1323-1329.
33. Dailey U.G. Intestinal tuberculosis. J. Natl. Med. Assoc., 1914, vol. 6, no. 4, pp. 228-233.
34. Debi U., Ravisankar V., Prasad K.K. et al. Abdominal tuberculosis of the gastrointestinal tract: revisited. World J. Gastroenterol., 2014, vol. 20, no. 40, pp. 14831-14840. https://doi.org/10.3748/wjg.v20.i40.14831
35. Dutta Gupta A.K. Clinical manifestations of abdominal tuberculosis from surgical aspect. Indian Med. Assoc., 1948, vol. 83, no. 6, pp. 258-261.
36. García-Rodríguez J.F., Álvarez-Díaz H., Lorenzo-García M.V. et al. Extrapulmonary tuberculosis: epidemiology and risk factors. Enferm. Infecc. Microbiol. Clin., 2011, vol. 29, no. 7, pp. 502-509. https://doi.org10.1016/j.eimc.2011.03.005
37. Global tuberculosis report, 2022. Geneva, World Health Organization, 2022. Avaliable: https://www.who.int/publications/i/item/9789240061729 Accessed March 12, 2025
38. Golden M.P., Vikram H.R. Extrapulmonary tuberculosis: an overview. Am. Fam. Physician, 2005, vol. 72, no. 9, pp. 1761-1768.
39. Haddad F.S., Ghossain A., Sawaya E., Nelson A.R. Abdominal tuberculosis. Dis. Colon Rectum., 1987, vol. 30, no. 9, pp. 724-735. https://doi.org/10.1007/BF02561699
40. Heemskerk D., Caws M., Marais B. et al. Tuberculosis in Adults and Children. London, Springer Publ., Chapter 2, Pathogenesis. 2015, 206 р.
41. Hoon J.R., Dockerty M.B., Pemberton J. Ileocecal tuberculosis including a comparison of this disease with nonspecific regional enterocolitis and noncaseous tuberculated enterocolitis. Int. Abstr. Surg., 1950, vol. 91, no. 5, pp. 417-440.
42. Kale A., Patil P.S., Chhanchure U. et al. Hepatic tuberculosis masquerading as malignancy. Hepatol. Int., 2022, vol. 16, no. 2, pp. 463-472. https://doi.org/10.1007/s12072-021-10257-9
43. Kentley J., Ooi J.L., Potter J. et al. Intestinal tuberculosis: a diagnostic challenge. Trop. Med. Int. Health, 2017, vol. 22, no. 8, pp. 994-999. https://doi.org/10.1111/tmi.12908
44. Kumar A., Kapoor V.K., Behari A., Verma S. Splenic tuberculosis in an immunocompetent patient can be managed conservatively: a case report. Gastroenterol. Rep. (Oxf.), 2018, vol. 6, no. 1, pp. 72-74. https://doi.org/10.1093/gastro/gov058
45. Leonard M. Tuberculosis in the mesenteric lymph nodes of children. Am. J. Dis. Child., 1931, vol. 41, no. 3, pp. 513-527. https://doi.org/10.1001/archpedi.1931.01940090030004
46. Liu S., Chen W., Shi J. et al. Clinical manifestation, imaging features and treatment follow-up of 29 cases with hepatic tubercolosis. Mediterr. J. Hematol. Infect. Dis., 2022, vol. 14, no. 1, pp. e2022063. https:// doi.org/10.4084/MJHID.2022.063
47. Mantilla J.C., Chaves J.J., Africano-Lopez F. et al. Gastrointestinal tuberculosis: an autopsy-based study. Infect. Med. (Beijing), 2023, vol. 2, no. 2, pp. 122-127. https://doi.org/10.1016/j.imj.2023.04.007
48. Marais B.J., Gie R.P., Schaaf H.S. et al. The clinical epidemiology of childhood pulmonary tuberculosis: a critical review of literature from the pre-chemotherapy era. Int. J. Tuberc. Lung Dis., 2004, vol. 8, no. 3, pp. 278-285.
49. Maulahela H., Simadibrata M., Nelwan E.J. et al. Recent advances in the diagnosis of intestinal tuberculosis. BMC Gastroenterol., 2022, vol. 22, no. 1, pp. 89. https://doi.org/10.1186/s12876-022-02171-7
50. McMullan G.S., Lewis J.H. Tuberculosis of the liver, biliary tract, and pancreas. Microbiol. Spectr., 2017, no. 5, pp. 10-18. https://doi.org/10.1128/microbiolspec.tnmi7-0025-2016
51. Mehta P.K., Raj A., Singh N., Khuller G.K. Diagnosis of extrapulmonary tuberculosis by PCR. FEMS Immunol. Med. Microbiol., 2012, vol. 66, no. 1, pp. 20-36. https://doi.org/10.1111/j.1574-695X.2012.00987.x
52. Mehta V., Desai D., Abraham P., Rodrigues C. Making a positive diagnosis of intestinal tuberculosis with the aid of new biologic and histologic features: how far have we reached? Inflamm. Intest. Dis., 2019, vol. 3, no. 4, pp. 155-160. https://doi.org/10.1159/000496482
53. Morley J. A post-graduate lecture on clinical aspects of abdominal tuberculosis. Br. Med. J., 1922, vol. 1, no. 3193, pp. 383-385.
54. Murphy T.F., Gray G.F. Biliary tract obstruction due to tuberculous adenitis. Am. J. Med., 1980, vol. 68, no. 3, pp. 452-454.
55. Ozturk N.B., Tsagkaris C, Dolek N., Iliaz R. Clinical presentation of peritoneal tuberculosis. Proc. (Bayl. Univ. Med. Cent.), 2022, vol. 36, no. 2, pp. 259-260. https://doi.org/10.1080/08998280.2022.2144706
56. Peto H. M., Pratt R. H., Harrington T. A. et al. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin. Infect. Dis., 2009, vol. 49, no. 9, pp. 1350-1357. https://doi.org/10.1086/605559
57. Polena H., Boudou F., Tilleu, S. et al. Mycobacterium tuberculosis exploits the formation of new blood vessels for its dissemination. Sci. Rep., 2016, no. 6, pp. 33162. https://doi.org/10.1038/srep33162
58. Rolleston H.D. Disease of the Liver, Gallbladder and Bile Ducts. Philadelphia, PA, WB Saunders Publ., 1905, 346 p.
59. Rolo M., González-Blanco B., Reyes C.A. et al. Epidemiology and factors associated with extra-pulmonary tuberculosis in a low-prevalence area. J. Clin. Tuberc. Other Mycobact. Dis., 2023, no. 32, pp. 100377. https://doi.org10.1016/j.jctube.2023.100377
60. Sheer T.A, Coyle W.J. Gastrointestinal tuberculosis. Curr. Gastroenterol. Rep., 2003, vol. 5, no. 4, pp. 273-278. https://doi.org/10.1007/s11894-003-0063-1
61. Shi X.C., Zhang L.F., Zhang Y.Q. et al. Clinical and Laboratory Diagnosis of Intestinal Tuberculosis. Chin. Med. J. (Engl.), 2016, vol. 129, no. 11, pp. 1330-1333. https://doi.org/10.4103/0366-6999.182840
62. Singh V., Kumar P., Kamal J. et al. Clinicocolonoscopic profile of colonic tuberculosis. Am. J. Gastroenterol., 1996, vol. 91, no. 3, pp. 565-568.
63. Swain J. The vagaries of abdominal tuberculosis: a clinical study. Bristol Medico-Chir. J., 1904, vol. 22, no. 83, pp. 31-39.
64. Vaid U., Kane G.C. Tuberculous peritonitis. Microbiol. Spectr., 2017, vol. 5, no. 1, pp. 10.1128. https://doi.org/10.1128/microbiolspec.TNMI7-0006-2016
65. Wang Z., Liu J.C., Chen Q.L. et al. A LIP abdominal tuberculosis classification system for surgery. Indian J. Surg., 2021, no. 83, pp. 100-106. https://doi.org/10.1007/s12262-020-02296-7
66. Winternitz M.C. Tuberculosis of the spleen. Arch. Intern. Med., 1912, vol. 9, no. 6, pp. 680-697.
67. Zhan F., Wang C.., Lin J.Z. et al. Isolated splenic tuberculosis: a case report. World J. Gastrointest. Pathophysiol., 2010, vol. 1, no. 3, pp. 109-111. https:// doi.org/10.4291/wjgp.v1.i3.109
Review
For citations:
Plotkin D.V. Abdominal Tuberculosis. Tuberculosis and Lung Diseases. 2026;104(1):86-99. (In Russ.) https://doi.org/10.58838/2075-1230-2026-104-1-86-99
Views:
340
JATS XML
Email this article 