ABSTRACT
Introduction: The incidence of abdominal tuberculosis has been steadily increasing over the past 20 years. The situation is worse in underdeveloped countries like Pakistan where poverty, overcrowding, unhygienic environment and recent outbreaks of multidrug resistant tuberculosis [MDR-TB] have posed more challenges for the management of abdominal tuberculosis. Tuberculous intestinal perforation is an even bigger challenge for the surgeons
Objectives: To reduce the morbidity and mortality related to tuberculous intestinal perforation vide application of Modified New Scoring system based upon simple pre-operative and intraoperative criterias
Patients and Methods: This descriptive study was conducted at surgical ward II, SZMC/Hospital, Rahimyar Khan, from 1[st] March 2009 to 31[st] August 2010 and 13 patients of tuberculous intestinal perforation were included in this study. Based on Modified New Scoring system, patients were divided into three groups. Group I were managed with primary closure, Group II with ileostomy, Group IIIA with peritoneal tube drainage and Group III B with tube enterostomy
Results: Overall, 12 [92%] patients developed wound infections, 2 [15.3%] presented with fecal fistula after surgery and were re-explored, and 3 [23%] patients developed burst abdomen due to fecal fistula or severe sepsis. The overall mortality was 2[15.3%] in this study which is less than other national/international studies
Conclusion: Modified new scoring system is practical to categorize the patients on the scale of severity of disease and to offer precise guideline to the surgeons for damage control with minimum injury and with good initial promising results