ABSTRACT
To assess the prevalence and presentation of intestinal tuberculosis in cases of mechanical bowel obstruction. Retrospective study from Oct. 1999 to Sept. 2005. Surgical Unit I, Abbasi Shaheed Hospital, Karachi. All patients [> 10 years of age] presenting with mechanical bowel obstruction. The data and files of all the cases of dynamic bowel obstruction was retrieved and analyzed with reference to age, sex, symptomatology and examination findings, investigations, aetiology, surgical procedures performed and outcome. A total of 163 patients were admitted with mechanical bowel obstruction over a period of six years. The ages of the patients varied between 10-74 years, maximum cases being seen between 30-40 years, with a male preponderance [60.1%]. Abdominal pain [40.5%], vomiting [20.2%] and constipation[16. 0%] were the prominent modes of presentation. Intestinal Tuberculosis [70.6%] was the most common cause of intestinal obstruction, followed by irreducible inguinal hernias [17.2%] and malignancies [7.4%]. Less than half [46.0%] the tuberculous patients were already on anti-tuberculous treatment at the time of presentation. About 9% of the tuberculous cases were managed conservatively, while the rest were operated upon; right hemicolectomy being the most frequent [47.6%] procedure performed. Histopathology was positive for tuberculosis in all the cases. Five patients of intestinal Tuberculosis died due to Tuberculous peritonitis. Intestinal Tuberculosis is the leading cause of mechanical bowel obstruction in our part of the world. Many patients of abdominal tuberculosis, managed conservatively on anti-tuberculous treatment, develop signs and symptoms of acute obstruction. Hence early surgical intervention is recommended to improve the morbidity and mortality of such patients