Abdominal Koch's (Tuberculosis)
It is a type of extrapulmonary TB which may involve various sites in the gastrointestinal tract- peritoneum, stomach, intestinal tract, hepatobiliary tree, pancreas, perianal area and lymph nodes.
May occur via reactivation of latent TB infection or ingestion of tuberculous mycobacterium or via hematogenous/ contiguous spread in the setting of active pulmonary / disseminated TB.
Risk factors include cirrhosis, HIV,diabetes mellitus,underlying malignancy, malnutrition, treatment with immunosuppresant drugs or corticosteroids.
Symptoms include abdominal pain, distension, abdominal fluid, intestinal obstruction, fever, altered bowel habits, weight loss and feeling of lump in the abdomen.
Diagnosis is often delayed. Disease is suspected on clinical history, physical examination and imaging techniques. Definitive diagnosis requires demonstrating Mycobacterium tuberculosis bacteria in fluid examination or biopsy obtained from colonoscopic examination of intestine.
Responds to treatment with Anti tuberculosis drugs.
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