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Abstract

Objective: To provide an insight into the presentation, diagnosis and management of gastrointestinal tuberculosis in children.

Methods: We reviewed the medical records of children who were diagnosed with gastrointestinal tuberculosis, between October 2013 and October 2023. The analysis was performed using descriptive statistics.

Results: During the study period, 11 of 76 tuberculosis pediatric patients (14.5%) were diagnosed with gastrointestinal tuberculosis. Six of 11 patients (54.5%) were female. The median age of the patients was 60 months (51-205 months). Eight of 11 patients had intra-abdominal lymph node involvement, 3 of 11 patients had intestinal tuberculosis and 2 of 11 patients had also active pulmonary tuberculosis. Multiple intra-abdominal areas were involved in 6 patients. Mean duration of symptoms before admission was 60 days (5-180 days). The most common symptoms were abdominal pain (63.7%), weight loss (63.7%) and weakness/fatigue (54.5%). Acid-fast bacilli and tuberculosis PCR were positive in only two patients. Tuberculosis culture positivity was detected in two patients, both of them showed M. bovis growth. Necrotizing granulomatous inflammation was the most frequently observed histopathological finding. Anemia was detected in 6 patients. There was elevated ESR in 8 patients and elevated CRP in 6 patients. In one patient, recurrent obstruction symptoms developed due to stenosis of terminal ileum. Clinical cure was achieved with supportive treatment.

Conclusion: Diagnosis of gastrointestinal tuberculosis is very difficult due to non-specific clinical and radiological features. Microbiological confirmation of the disease is often challenging. Making a definitive diagnosis requires reliance on strong clinical suspicion, imaging and histopathological findings, microbiological tests, and/or response to treatment.

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