AIM:To evaluate the clinical,radiological and microbiologicalproperties of abdominal tuberculosis (TB) and to discussmethods needed to get the diagnosis.METHODS:Thirty-one patients diagnosed as abdominalTB between March 1998 and December 2001 at theGastroenterology Department of Kartal State Hospital,Istanbul,Turkey were evaluated prospectively.Completephysical examination,medical and family history,blood counterythrocyte sedimentation rate,routine biochemical tests,Mantoux skin test,chest X-ray and abdominalultrasonography (USG) were performed in all cases,whereasmicrobiological examination of ascites,upper gastrointestinalendoscopy,colonoscopy or barium enema,abdominaltomography,mediastinoscopy,laparoscopy or laparotomywere done when needed.RESULTS:The median age of patients (14 females,17males) was 34.2 years (range 15-65 years).The mostfrequent symptoms were abdominal pain and weight loss.Eleven patients had active pulmonary TB.The mostcommon abdominal USG findings were ascites andhepatomegaly.Ascitic fluid analysis performed in 13 patientswas found to be exudative and acid resistant bacilli werepresent in smear and cultured only in one patient withBacTec (3.2%).Upper gastrointestinal endoscopy yieldednonspecific findings in 16 patients.Colonoscopy performedin 20 patients showed ulcers in 9 (45%),nodules in 2 (10%)and,stricture,polypoid lesions,granulomatous findings interminal ileum and rectal fistula each in one patient (5%).Laparoscopy on 4 patients showed dilated bowel loops,thickening in the mesentery,multiple ulcers and tubercleson the peritoneum.Patients with abdominal TB were dividedinto three groups according to the type of involvement.Fifteen patients (48%) had intestinal TB,11 patients(35.2%) had tuberculous peritonitis and 5 (16.8%)tuberculous lymphadenitis.The diagnosis of abdominal TBwas confirmed microbiologically in 5 (16%) and histo-pathologically in 19 patients (60.8%).The remaining ninepatients (28.8%) had been diagnosed by a positiveresponse to antituberculous treatment.CONCLUSION:Neither clinical signs,laboratory,radiologicaland endoscopic methods nor bacteriological andhistopathological findings provide a gold standard bythemselves in the diagnosis of abdominal TB.However,analgorithm of these diagnostic methods leads to considerablyhigher precision in the diagnosis of this insidious disease which primarily necessitate a clinical awareness of this serioushealth problem. AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discussmethods needed to get the diagnosis. METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital, Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood countery throcyte sedimentation rate, routine biochemical tests, Mantoux skin test, chest X-ray and abdominalultrasonography (USG) were performed in all cases, while microbiological examination of ascites, upper gastrointestinalendoscopy, colonoscopy or barium enema, abdominaltomography, mediastinoscopy, laparoscopy or laparotomywere done when needed .RESULTS: The median age of patients (14 females, 17males) was 34.2 years (range 15-65 years). the mostfrequent symptoms were abdominal pain and weight loss. Eleven patients had active pulmonary TB. most most commet abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2%). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 ( 45%), nodules in 2 (10%) and, stricture, polypoid lesions, granulomatous findings interminal ileum and rectal fistula each in one patient (5%). Laparoscopy on 4 patients showed dilated bowel loops, thickening in the mesentery, multiple ulcers and tubercleson the peritoneum. Patients with abdominal TB were dividedinto three groups according to the type of involvement .Fifteen patients (48%) had intestinal TB, 11 patients (35.2%) had tuberculous peritonitis and 5 (16.8%) tuberculous lymphadenitis.The diagnosis of abdominal pain was microbiologically in 5 (16%) and histo-pathologically in 19 patients (60.8%). The remaining nine patients (28.8%) had been diagnosed by a positive responseto antituberculous treatment. CONCLUSION: Neither clinical signs, laboratory, radiologicaland endoscopic methods nor bacteriological and histopathological findings provide a gold standard by the personality in the diagnosis of abdominal TB. However, analgorithm of these diagnostic methods leads to substantial acceleration in the diagnosis of this insidious disease which about necessitate a clinical awareness of this serioushealth problem