INTESTINAL TUBERCULOSIS

PATTERN OF PRESENTATION AND SURGICAL MANAGEMENT

Abstract

Tuberculosis is one of the leading causes of morbidity and mortality, responsible
for annual 7–10 million new cases and 6 per cent of deaths in developing countries. It can
involve any part of abdomen but most common is intestinal tract in which it can present with
wide variety of symptoms. Early diagnosis and appropriate management is challenging for
clinicians. Objectives: To determine the modes of presentation of abdominal tuberculosis
and 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 December
2014. Materials and Methods: 50 patients with abdominal tuberculosis were included in
the study. Histopathology confirmed the diagnosis of abdominal tuberculosis. Age, gender,
mode of presentation, evidence of co-existing tuberculosis, family history, drug history of antituberculous
treatment, laboratory and radiological investigations, treatment modalities and
duration 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 subacute
intestinal obstruction, 16% with acute intestinal obstruction and 14% with peritonitis. All 50
patients underwent laparotomy. Ileocecal mass with perforation (40%) was seen as the most
common per-operative finding. Limited right hemicolectomy with ileocolostomy (44%) was
performed 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 obstruction
in our setup, with a variable mode of presentation. Early diagnosis with appropriate surgical
management and chemotherapy can prevent significant morbidity and mortality.