Spectrum of Clinical Presentations and Surgical Management of Tuberculous Small Intestinal Obstruction

Abstract

Background: The causes of acute Intestinal Obstruction vary demographically. In the developing world, tuberculosis account for more than half of all cases of small bowel obstruction. Tuberculosis is a major health burden in developing countries. It can result some medical as well as surgical emergencies. Among the surgical emergencies, small gut obstruction is the burning issue. It can show wide spectrum of presentations. Objective: To find out spectrum of clinical presentations and surgical management of tuberculous small intestinal obstruction. Methods: It was a cross- sectional study conducted in the Department of Surgery, Sher-E-Bangla Medical College Hospital from July 2015 to December 2015. A total of 100 patients were selected by purposive sampling methods. The detail history and clinical examination findings were recorded including patient’s demographic profile and clinical as well as investigation findings. Preoperative findings and post-operative complications were also observed and recorded. Results: According to the result analysis, maximum patients were young adult and the highest patients (54%) came from 21-30 year’s age group followed by 31-40 year’s age group (18%). Among the respondents, 62% were male and 38% were female patients. The male to female ratio was 1.63:1. The results of clinical presentations revealed that all (100%) patients presented with abdominal pain followed by abdominal distension (78%) as small gut obstruction was mostly prevalent. Besides, constitutional features like weight loss and low grade and evening rise of temperature were present in almost all tuberculous patients. Operative findings revealed that single/multiple small bowel stricture in 80% patients followed by bands and adhesion in 14% patients. Strictures as well as perforation were present in case of 11% patients. Maximum operative procedures performed right hemicolectomy with ileo- transverse anastomosis (58%) followed by segmental bowel resection with end ........