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Fırat Tıp Dergisi
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Clinical Spectrum of Extrapulmonary Tuberculosis from Pediatric Surgical Perspective
İdil Rana USER, Bülent Hayri ÖZOKUTAN
Gaziantep Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Gaziantep, Türkiye
Keywords: Tüberküloz, Ekstrapulmoner, Çocuk, Tuberculosis, Extrapulmonary, Child
Summary
Objective: To identify modes of clinical presentation in extrapulmonary tuberculosis of childhood.

Material and Method: All children diagnosed with extrapulmonary tuberculosis in a pediatric surgery clinic during the years 2000-2017 were re-viewed retrospectively. Their files were evaluated for clinical presentation, laboratory and radiologic findings, pathology results, surgical details and postoperative complications.

Results: Six girls and seven boys with the median age of 36 months were evaluated. The most common affected area was axillary lymph nodes in 8 patients and excisional biopsy was performed in all of them. The other foci of tuberculosis were intraabdominal. Abscess emerging from psoas musc-le were drained in 2 patients. Ileocecal resection in one and adhesiolysis and biopsy from intestinal wall were performed in the other patient with intestinal involvement. Incisional biopsy was taken in adolescent with ovarian tuberculosis. A congenital immunodeficiency syndrome accompanied in 5 patients and further investigation proved miliary tuberculosis in 2 of them. History of contact with tuberculosis was positive in 4 children. Patho-logic examination of surgical specimen showed caseification necrosis in 6 and granulomatous inflammation in all of the cases. Microbiologic eviden-ce for tuberculosis infection was positive in 5 cases. Postoperative complication were adhesive intestinal obstruction in one and skin fistulization in 4 patients. Except the child with miliary tuberculosis and immunodeficiency, all other patients survived the disease with antituberculosis treatment.

Conclusion: Extrapulmonary tuberculosis may be present with various clinical pictures. Surgery has an important role in tissue diagnosis and in complications caused by the disease.

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