ABSTRACT
Background: The objective of this study is to evaluate diagnosed cases of abdominal tuberculosis (TB) in terms of incidence,manifestation in different age groups, clinical presentations, treatment received (conservative or surgical), lesions foundintraoperatively, and its outcome on follow-ups.Methods: It is a retrospective study with 25 cases of abdominal TB treated at Guru Gobind Singh Hospital, Jamnagar, duringthe period of 2005–2007. Detailed history, physical examination, necessary investigations such as complete blood counts, ESR,urine examination, sputum examination, and radiological investigations were prescribed in all cases. Barium study, Mantouxtest, ascitic fluid examination, and computed tomography scan abdomen were carried out when indicated. Tissue or biopsymaterials were histologically examined. Results were analyzed with patient’s health status.Results: In 25 case series of abdominal TB, the average age of presentation was between 10 and 40 years with definitemale predominance (male:female = 3:2). Most of the patients belonged to low socioeconomic class which, in turn, reflectsovercrowding, undernourishment, bad sanitation, and poor hygiene in living conditions. In our study, ESR was raised in morethan 90% of patients. Abdominal pain was the most common presenting symptom followed by anorexia, fever, and vomiting.About 25% of patients were having TB foci in lung either active or healed lesion. Uncorrected anemia, malnutrition, andpulmonary TB were all contributory to poor prognosis and prolonged morbidity. Anti-TB drugs gave most satisfactory resultsin our patients.Conclusions: Koch’s abdomen is a clinical entity with varied clinical presentation. It is very common in tropics and maypresent with complications. Most of the patients are cured with conservative treatment and anti-TB drugs. Surgery is requiredin case of complications only. No drug-resistant cases have been found in this study. Investigations have played major role inconfirmation of disease.
ABSTRACT
Introduction: Blunt abdominal trauma occurs when injuryto organs inside abdominal cavity is present due to externalforces exerted over abdomen as result of trauma. Widespectrum of clinical presentation is seen ranging from milderforms of injury to fatal solid organ injuries with irreversibleshock and ongoing bleeding. Management ranges fromwatchful observation to emergency laparotomy. Aim ofthis study was to evaluate different clinical presentation,organ specific injury and management of blunt abdominaltrauma.Material and Methods: A retrospective study with 25patients sustaining Blunt abdominal trauma who came toTrauma centre in Guru Gobindsingh Government Hospital,Jamnagar attached to medical college from 2016 to 2018 wereincluded. The patients were selected randomly.Results: Blunt abdominal injury was seen in all age from 1 to60 years. Highest incidence noted in age group 11 to 20 years.Male predominance was noted with Male: Female ratio21:4 of5.25:1.Most common mode of injury was road traffic accident(44%). Most common injured organ was Liver (32%).Liver and spleen injuries were associated with rib fractures.Abdominal pain and tenderness was most common clinicalpresentation (90%). Patients with hemodynamic instabilityhad more mortality.Conclusion: Blunt abdominal injury is one of the commonestinjuries encountered in polytrauma patients. Morbidity andmortality can be prevented by timely initial resuscitation andcorrect diagnosis as well as management (operative or nonoperative) which depend on patient’s hemodynamic stabilityand findings of imaging studies.