ABDOMINAL TUBERCULOSIS AND MIMICKERS: A DIAGNOSTIC DILEMMA AND THE ROLE OF EARLY SURGICAL EXPLORATION IN AMBIGUOUS CASES

This study evaluated the importance of early surgical exploration in suspected abdominal tuberculosis (ATB) cases lacking microbiological or histopathological conrmation. Surgery provided denitive diagnoses in all cases, identifying non-ATB and drug-resistant TB cases, despite empirical anti-tuberculosis therapy (ATT) initiation based on clinical suspicion. Shorter empirical ATT duration before surgery correlated with better outcomes. The study highlights the need for standardized diagnostic protocols prioritizing conrmatory testing, limiting empirical ATT to settings without such diagnostics. Improving ATB management requires multidisciplinary collaboration and increased use of minimally invasive techniques like laparoscopy. Early surgical exploration enables direct tissue sampling for histopathological conrmation, reducing reliance on empirical ATT and minimizing complications and mortality from inappropriate treatment. Integrating surgical diagnostics into a multidisciplinary approach ensures targeted treatments and reduces drug-resistant tuberculosis. Prioritizing denitive diagnosis before initiating ATT prevents misdiagnoses, optimizes patient care, and supports public health strategies for controlling and eliminating this infectious disease