Page 398 - Abstract Book KONIKA 18

Respirology

P-RES-016 (Prime e-Poster)
Childhood Tuberculosis with Special Attention in Abdominal Tuberculosis

Prajnya Paramitha Narendraswari, Darmawan Budi Setyanto, Nastiti Kaswandani
Department of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia
Abstract
Background Abdominal tuberculosis (TB) in children has unspecific symptoms and often overlooked. We
evaluated pediatric TB patient with abdominal symptoms/sign. Objective To emphasize the importance of
diagnosing abdominal TB. Methods A retrospective study was done from 1 January 2017 to 28 April 2021 of
all children (<18 years) treated as TB. Demographic and clinical data were collected through health records,
laboratory and imaging reports. Results During the 4-year period, there were 626 children diagnosed with TB,
58% (366/626) were pulmonary TB and 0.04% (27/626) abdominal TB. None of patient with abdominal TB
had HIV. Mean age of subject was 11,9, predominantly girls (59%), with mean TB scoring of 4. Symptoms/
signs were weight loss (74%), fever (63%), cough (33%), and palpable-lymph node (29%). Abdominal
symptoms were pain (81%), abdominal distention (81%), anorexia (74%), vomiting (59%), diarrhea (51%)
and hepatomegaly (22%). Tuberculin test and IGRA were done in 10 and 7 patients with positivity rate of
60% and 71%, respectively. Only 1 patient had a positive mycobacterium TB culture. Chest x-ray was done
in 17 patients and most (71%) were suggestive of TB. Abnormal abdominal CT or ultrasonography was
found in 48% (13/27) subjects. Nine children died during therapy. Conclusion Incidence of abdominal TB
was rare, but mortality was high. In pediatric pulmonary TB case with abdominal symptoms, suspicion of
abdominal TB should always be considered. Chest x-ray was important in diagnosing pulmonary TB, but
an additional abdominal CT or ultrasonography can aid in the diagnosis of abdominal TB.
Keywords: tuberculosis; pulmonary tuberculosis; abdominal tuberculosis; childhood tuberculosis;
adolescent tuberculosis

P-RES-017
Clinical Features and Management of Abdominal Tuberculosis in Children:
A Case Series

Ratih Kumala Sari, Rika Hapsari, Arda Pratama Putra C, Retno Asih Setyoningrum
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr Soetomo General Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Abdominal Tuberculosis (TB) is a part of extra-pulmonary TB. However, diagnosis of
abdominal TB in children is challenging due to a lack of specific symptoms and pathognomonic findings.
Objective Present various clinical features of abdominal TB in children and its management. Cases First
case, a 13-year-old girl, presenting with abdominal pain and weight loss, underwent Mantoux test, and
abdominal CT, revealed peritonitis TB fibrotic type and polyp at colon. Second case, a 13-year-old girl,
presenting with prolonged fever, cough, and abdominal pain, revealed miliary TB and from abdominal CT
revealed lymph node type of abdominal TB. Third and fourth cases, a 6-year-old girl and a 9-year-old boy,
both presenting with abdominal pain and fever. Abdominal CT of third case revealed lymph node type and
of fourth case revealed peritonitis and lymph node type. Fifth case, an 8-year-old girl, presenting with high
fever, pale, cough, and weight loss, and abdominal CT revealed liver abscess (sero-hepatic type). Sixth
case, a 15-year-old boy, presenting with abdominal pain and enlargement, form BOF and abdominal US,
revealed peritonitis, underwent laparotomy exploration and intestine tuberculoma was found. All cases
were given anti-TB drugs. Corticosteroid only for two cases. All cases were given nutritional support. Only
a case underwent surgery. Conclusion The most common symptom was abdominal pain in various types
of abdominal TB. Management of abdominal TB included Anti-TB drugs, corticosteroids, and nutritional
support. Surgery was rarely performed.
Keywords: extra-pulmonary TB; abdominal TB; peritonitis; intestinal

350 KONIKA XVIII Abstract Book