Background: Gastrointestinal tuberculosis (GITB) is an underrecognized form of extrapulmonary TB that often presents with nonspecific symptoms, leading to diagnostic delay and adverse outcomes. Data describing its clinical characteristics, diagnostic approaches, and outcomes in the Middle East, particularly Saudi Arabia, remain limited. Methods: We conducted a retrospective cohort study of adult patients (≥18 years) diagnosed with GITB at a tertiary care center in Saudi Arabia between January 2012 and December 2022. Diagnosis was based on microbiological confirmation, histopathological findings consistent with TB, or compatible clinical–radiological features with documented response to antituberculous therapy. Demographic characteristics, comorbidities, clinical presentation, diagnostic modalities, treatment regimens, and outcomes were analyzed descriptively, with exploratory subgroup comparisons. Results: A total of 47 patients were included; 72.3% were male, with a mean age of 59.1 years. Diabetes mellitus (42.6%) and chronic kidney disease (25.5%) were the most common comorbidities. Abdominal pain (80.9%) and weight loss (57.4%) were the most frequent presenting symptoms, with a median diagnostic delay of 60 days. Disseminated disease was identified in 36.2% of patients. Microbiological confirmation was achieved in 42.6% by acid-fast bacilli staining and 34.0% by mycobacterial culture, while molecular testing (Xpert MTB/RIF) was performed in a minority of cases. Clinical cure was achieved in 76.6% of patients, and the overall mortality was 10.6%. Conclusions: GITB in Saudi Arabia is characterized by nonspecific presentation, frequent diagnostic delay, and a high burden of chronic comorbidities, with a substantial proportion of disseminated disease. Despite generally favorable treatment outcomes, mortality remains notable. Improved utilization of molecular diagnostics and earlier recognition in high-risk populations may enhance clinical outcomes.
Alsaeed et al. (Thu,) studied this question.