Surgical management of abdominal tuberculosis:a retrospective study from Central India

Authors

  • Kailash Charokar Department of Surgery, People’s College of Medical Sciences & Research Centre, Bhopal, M.P, India
  • Nitin Garg Department of Surgery, People’s College of Medical Sciences & Research Centre, Bhopal, M.P, India
  • Ajay Kumar Jain Department of Surgery, People’s College of Medical Sciences & Research Centre, Bhopal, M.P, India

DOI:

https://doi.org/10.18203/2349-2902.isj20151217

Keywords:

Abdominal tuberculosis, Intestinal stricture, Bowel perforation, Resection anastomosis, Ileostomy

Abstract

Background: Abdominal tuberculosis is a diagnostic and therapeutic challenge in resource limited countries. The vague clinical presentation is a barrier to early diagnosis. The study aims to highlight the role of surgery in the diagnosis and treatment of abdominal tuberculosis.

Methods: This is a descriptive study of abdominal tuberculosis cases, which were operated in the Department of Surgery, Peoples College of Medical Sciences & Research Centre, Bhopal from August 2010 to July 2015. Cases were analyzed in terms of demography, clinical features, investigations, operative treatment, and outcome.

Results: 72 cases of abdominal tuberculosis were operated during the study period. The median age was 30 years with male to female ratio of 3:2. Primary abdominal tuberculosis was 79.2%. Intestinal tuberculosis was the commonest with terminal ileum and ileo-caecal region being predominantly involved. 58% of the patients required emergency surgery. Surgical procedures performed were: resection of the diseased segment including right hemi-colectomy 32 (44.44%), release of band/adhesions 23 (31.9%), perforation repair 11 (15.3%), stricturoplasty 4(5.5%), etc. In the presence of gross peritonitis, temporary ileostomy was performed. Complication and mortality rates were 33.3% and 2.6% respectively. No patient had post-operative intestinal-leak.The median duration of hospital stay was 14 days.

Conclusions: Early diagnosis is the key factor in avoiding systemic and local complications of intestinal tuberculosis. In emergency cases, prompt surgical exploration and vigilant care is met with good recovery. Resection-anastomosis in the form of right hemi-colectomy or segmental resection has largely been adopted instead of simple bypass of obstructive lesions with good results.

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Published

2016-12-13

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Original Research Articles