RESUMEN
A retrospective study of 27 patients presenting with intestinal obstruction, with a strong suspicion of abdominal tuberculosis on admission was carried out at the surgical unit-3, Civil Hospital, Karachi, during the period of 15 months, from October '99 to December '2000. 20 patients [74 percent] were admitted through the emergency department. Among them 16 [59.2 percent] were females mostly in the 20- 40 age group and 11 [40.7 percent] were males in the 30 to 50 age group. Of the 27 cases 9 were known cases of abdominal tuberculosis on admission. 4 cases [14.8 percent] responded well on conservative management on anti-tuberculous therapy, all of the remaining 23 cases [85.1 percent] underwent surgical intervention. Of these 22 cases were provisionally diagnosed as Abdominal Koch's; the criteria of which were based on clinical presentation, laboratory investigations, and radiology and per-operative findings. The most common operative finding was of the multiple strictures of the small bowel. Out of 23 patients operated for acute intestinal obstruction, 17 cases [73.9 percent] were finally diagnosed as abdominal tuberculosis on histopathology. Segmental resection, bypass procedures, and right hemi-colectomy were the common operative procedures, performed on these patients. Abdominal tuberculosis can be difficult to diagnose pre operatively and thus a delay can affect the proper management and increase the morbidity. So an early diagnosis can make a difference in the prognostic outcome