背景:腹部结核以多种方式出现。除了具有高度的临床怀疑以诊断和开始治疗之外,还必须应用不同的测试模式。药物反应良好;然而,在对肠梗阻和穿孔等复杂表现进行手术治疗后,已经看到了发病率。在小儿年龄组中,很少有研究评估对不同治疗方案的反应并确定与腹部结核患儿预后较差相关的因素。
方法:使用问卷评估单中心75例腹部结核患儿的患者记录,涵盖2007年至2021年的14年期间。人口统计特征,出现体征和症状,调查和治疗细节进行了研究。进行面对面或电话随访以确定治疗结果。
结果:腹部结核发病率为7%,在所有结核病儿童中,平均年龄为10.1岁。67%的病例涉及肠系膜淋巴结,33%的病例涉及小肠。22名儿童需要手术。85%的儿童完成了治疗。小肠受累接受手术的可能性更高。在70名完全随访的儿童中,64例良好,6例儿童死于该疾病。年纪大了,小肠受累和手术与较高的死亡率独立相关.
结论:肠道受累与更大的手术干预需求和更大的死亡率相关。青少年的结果较差。需要进一步的研究集中在这些单独的子组,以了解呈现的模式,死亡原因和预防。
方法:第5级。
BACKGROUND: Abdominal tuberculosis presents in a variety of ways. Different testing modalities must be applied in addition to having a high clinical suspicion to diagnose and initiate therapy. Medications have a good response; however, morbidity has been seen following surgical management of complicated presentations like intestinal obstruction and perforation. There is a paucity of studies in the pediatric age group which evaluate response to the different treatment regimen and identify factors associated with poorer outcomes in children with abdominal tuberculosis.
METHODS: Patient records of 75 children with abdominal tuberculosis at a single center were evaluated using a questionnaire, covering a 14-year period from 2007 to 2021. Demographic features, presenting signs and symptoms, investigations and treatment details were studied. In- person or telephonic follow-up was conducted to identify treatment outcomes.
RESULTS: Incidence of abdominal TB was 7%, of all TB children with a mean age of 10.1 years. Mesenteric lymph nodes were involved in 67% and small intestine in 33% cases. Surgery was required in 22 children. 85% children completed treatment. Small intestine involvement had higher probability of undergoing surgery. Of the 70 children with complete follow up, 64 were well and 6 children succumbed to the disease. Older age, small intestine involvement and surgery were independently associated with higher mortality.
CONCLUSIONS: Intestinal involvement is associated with greater need for surgical intervention and greater mortality. Adolescents have poorer outcomes. Further studies are required focusing on these individual subgroups to understand the patterns of presentation, causes for mortality and prevention.
METHODS: Level 5.