Published: 2020-03-26

Surgical management and post-operative complications in abdominal tuberculosis patients

Mahendra Kumar


Background: Abdominal tuberculosis is a diagnostic and therapeutic challenge in resource limited countries. The vague clinical presentation is a barrier to early diagnosis. Aim of the study was to highlight the role of operative procedures and post-operative complications in patients suffering from abdominal tuberculosis.

Methods: This is a descriptive study of abdominal tuberculosis cases, which were operated in the Department of Surgery, Lal Lajpath Rai hospital Kanpur, Uttar Pradesh, India, and associated hospitals. Informed and written consent was obtained from each patient prior to commencement of the study. Detailed data of each patient was entered on a Microsoft excel. Data were presented in number and percentages.

Results: Most of the patient’s lumps were present in right ileac fosa, 70.37% followed by lymph node mass. Rolled omentum and appendicular showed minimum percentage of cases. In operative finding on exploratory laparotomy, the most common site of involvement was ileocaecal, and less commonly involved site in abdomen tuberculosis are duodenum and appendix. Surgical procedures, intestinal resection in the form of right hemicolectomy (21 cases), small bowel resection (58 cases). Appendicectomies were done only in 3 cases. Post-operative complications were found in 64 cases. Most of the complication developed in patients those were operated in emergency.

Conclusions: Most of the surgeons were preferred conservative surgery rather than extensive resection of the active lesion. Commonest post-operative complication was broncho pulmonary complication.


Abdominal tuberculosis, Bowel perforation, Resection anastomosis, Stricture

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Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep. 2003;5(4):273-8.

Farer LS, Lowell AM, Meador MP. Extrapulmonary tuberculosis in the United States. Am J Epidemiol. 1979;109(2):205-17.

Donoghue HD, Holton J. Intestinal tuberculosis. Curr Opin Infect Dis. 2009;22(5):490-6.

Lingenfelser T, Zak J, Marks IN, Steyn E, Halkett J, Price SK. Abdominal tuberculosis: still a potentially lethal disease. Am J Gastroenterol. 1993;88(5):744-50.

Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88(7):989-99.

Park SH, Yang SK, Yang DH, Kim KJ, Yoon SM, Choe JW, et al. Prospective randomized trial of six-month versus nine-month therapy for intestinal tuberculosis. Antimicrob Agents Chemother. 2009;53(10):4167-71.

Ramesh J, Banait GS, Ormerod LP. Abdominal tuberculosis in a district general hospital: a retrospective review of 86 cases. QJM. 2008;101(3):189-95.

Mamo JP, Brij SO, Enoch DA. Abdominal tuberculosis: a retrospective review of cases presenting to a UK district hospital. QJM. 2013;106(4):347-54.

Prakash A. Ulcero-constrictive tuberculosis of the bowel. Int Surg. 1978;63:23-9.

Debi U, Ravisankar V, Prasad KK, Sinha SK, Sharma AK. Abdominal tuberculosis of the gastrointestinal tract: revisited. World J Gastroenterol. 2014;20(40):14831-40.

Bolukbas C, Bolukbas FF, Kendir T, Dalay RA, Akbayir N, Sokmen MH, et al. Clinical presentation of abdominal tuberculosis in HIV seronegative adults. BMC Gastroenterol. 2005;5:21.

Lazarus AA, Thilagar B. Abdominal tuberculosis. Dis Mon. 2007;53(1):32-8.

Khan R, Abid S, Jafri W, Abbas Z, Hameed K, Ahmad Z. Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians. World J Gastroenterol. 2006;12(39):6371-5.

Arnold C, Moradpour D, Blum HE. Tuberculous colitis mimicking Crohn’s disease. Am J Gastroenterol. 1998;93:2294-6.

Kaushik SP, Bassett ML, McDonald C, Lin BP, Bokey EL. Case report: gastrointestinal tuberculosis simulating Crohn’s disease. J Gastroenterol Hepatol. 1996;11:532-4.

Kirsch R, Pentecost M, Pde HM, Epstein DP, Watermeyer G, Friederich PW. Role of colonoscopic biopsy in distinguishing between Crohn’s disease and intestinal tuberculosis. J Clin Pathol. 2006;59:840-4.

Das P, Shukla HS. Clinical diagnosis abdominal tuberoclosis. Brit J Surg. 1976;63:941.

Bhansali SK. The challenges of abdominal tuberculosis in 310 cases. Ind Jr Surg. 1978;40:65.

Kapoor VK, Sharma LK. Abdominal tuberculosis. Br J Surg. 1988;75(1):2-3.

Tiwari VS, Singh NB. Abdominal tuberculosis- A surgical spectrum. Surgery. 1994;4:8.

Kumar R, Saddique M, Iqbal P, Khan NA. Abdominal tuberculosis: clinical presentation and outcome. Pak J Surg. 2007;23(4):242-4.

Rajput MJ, Memon AS, Rani S, Hamad A. Clinipathological profile and surgical management outcomes in patients suffering from intestinal tuberculosis. J Liaqual Uni Med Health Sci. 2005;4:113-8.

Eggleston FC. Surgery abdominal tuberculosis result in 137 cases. Ind Jr Tub. 1983;30:139.

Jain JK, Jain TC, Baid JC. Conservative surgery (stricturo – plasty) in intestinal tuberculosis. Ind Jr Surg. 1988;4:279-85.

Kapoor VK, Gupta S, Sikora SS, Chattopadhyay TK, Sharma LK. Acute tubercular abdomen. Ind J Surg. 1991;53:71.