Article

Cold Abscess of the Anterior Abdominal Wall: An Unusual Primary Presentation

Department of General Surgery, SGT Medical College, Hospital and Research Institute, Gurgaon, India.
Nigerian journal of surgery : official publication of the Nigerian Surgical Research Society 01/2012; 18(1):22-3. DOI: 10.4103/1117-6806.95481
Source: PubMed

ABSTRACT

Tuberculosis is considered as ubiquitous disease as it involves any organ, but primary involvement of abdominal muscles is very rare. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. Autopsy studies have shown abdominal wall involvement in less than 1% of patients who died of tuberculosis. Antitubercular therapy is main form of management. Surgical intervention is always secondary in the form of either sonography or computerized tomography-guided aspiration or open drainage which is usually reserved for patients in whom medical treatment has failed. A case is hereby reported about primary tubercular anterior abdominal wall abscess without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an apparently healthy individual with any past history of contact or previous antituberculosis therapy.

Download full-text

Full-text

Available from: ajol.info, Aug 12, 2015 · License: CC BY-NC-SA
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The skeletal muscles are rarely affected by tuberculosis because they are not a favorable site for the survival and multiplication of Mycobacterium tuberculosis. A case of tuberculous abscess in rectus abdominis muscle is described in a 20-year-old female in an apparently healthy individual without any past history of tuberculosis. The diagnosis was made by ultrasound-guided fine-needle aspiration and cytological examination which revealed caseating granuloma with central necrosis, lymphocytes, and giant cells, consistent with tuberculosis. After four weeks' antituberculous treatment, she responded well and the abscess regressed considerably. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. This case cautions the clinicians and radiologists about the possibility of tuberculosis in considering the differential diagnosis of any lesion even in any unlikely anatomical area, especially in those areas where tuberculosis is endemic.
    Full-text · Article · Oct 2015