A study of 150 cases of intraperitoneal tuberculosis

Abstract

Background: Tuberculosis caused by Mycobacterium tuberculosis is a disease of great antiquity and for a long time it has maintained its evil reputation and being one of the greatest killer diseases of mankind. The symptom of intraperitoneal tuberculosis is generally vague and nonspecific. It may mimic any intra-abdominal disease and can challenge the diagnostic skills. Tuberculosis of the ileocecal region ranks first in the incidence among intestinal/intraperitoneal tuberculosis. Objective: To know the various modes of presentation; different modalities of diagnosis with special reference to role of laparoscopes and treatment and prognosis in our setup, which helps in better management of these cases thus helping to improve prognosis. Materials and Methods: This is a clinical study of 150 cases of intraperitoneal tuberculosis admitted to Civil Hospital, Ahmedabad in the year 2006–2009. This study included selection of patient with intraperitoneal tuberculosis on a prospective basis. Result: Of 150 patients in our study, majority of the patients fall within the middle age group. Ascites and bowel disturbances are the most common symptoms. All patients were either given anti-Koch’s treatment (AKT) only or given AKT along with the surgery (before or after). Majority of the patients who responded to AKT alone were those with pure ascitic forms of tuberculosis. Patients treated with primary surgery included those who presented in the emergency and with complications of surgery or with significant obstructive symptoms. Majority undergo the knife in the form of either right hemicolectomy/ileo-ascending anastomosis or resection and anastomosis of the small intestine for intestinal stricture. Mortalities were 12% in this study, most of the patients who died were coming late stage with septicemia, perforation, peritonitis and associated pneumonia, and respiratory failure. Conclusion: Majority of the patients who required surgery were diagnosed as intraperitoneal tuberculosis primarily or after given primary AKT trial. All the patients must be given AKT full course as per directly observed treatment short-course under Revised National Tuberculosis Control program to cure the disease.