INTESTINAL TUBERCULOSIS

Abstract

Tuberculosis is one of the leading causes of morbidity and mortality, responsiblefor annual 7–10 million new cases and 6 per cent of deaths in developing countries. It caninvolve any part of abdomen but most common is intestinal tract in which it can present withwide variety of symptoms. Early diagnosis and appropriate management is challenging forclinicians. Objectives: To determine the modes of presentation of abdominal tuberculosisand effectiveness of surgical procedures in our setup. Study Design: A retrospective study.Setting: Surgical unit-I of Holy Family Hospital, Rawalpindi. Period: January 2014 to December2014. Materials and Methods: 50 patients with abdominal tuberculosis were included inthe study. Histopathology confirmed the diagnosis of abdominal tuberculosis. Age, gender,mode of presentation, evidence of co-existing tuberculosis, family history, drug history of antituberculoustreatment, laboratory and radiological investigations, treatment modalities andduration of hospital stay were recorded. Results: There were 28 female (56%) and 22 male(44%) patients with a mean age of 29± 10.23 years. 56% patients presented with subacuteintestinal obstruction, 16% with acute intestinal obstruction and 14% with peritonitis. All 50patients underwent laparotomy. Ileocecal mass with perforation (40%) was seen as the mostcommon per-operative finding. Limited right hemicolectomy with ileocolostomy (44%) wasperformed in most of the cases. Mean length of hospital stay was 10 ± 4.67 days. Conclusion:Abdominal tuberculosis is a common cause of acute abdomen especially intestinal obstructionin our setup, with a variable mode of presentation. Early diagnosis with appropriate surgicalmanagement and chemotherapy can prevent significant morbidity and mortality.