Abdominal tuberculosis Surgeons perspective

ABSTRACT

The aim was to analyze the clinical presentation and outcome of therapeutic procedures in abdominal tuberculosis. Design: Descriptive study. Place and Duration Surgical Unit III, Department of Surgery, Jinnah Postgraduate Medical Centre Karachi, of 4 years. All admitted patients [83] with following criteria were included. A. Clinically suspected abdominal tuberculosis supported by investigation and later responding to anti tuberculous drugs. B. Gross morphological operative findings; and histologically proven caseating chronic granulomatous inflammation. Median follow up was 9 months. Young females of low-income group were the common sufferers. Abdominal pain, intestinal obstruction and peritonitis were common presentations. Surgical interventions like loop ileostomy, resection anastomosis and adrenolysis were done in 53% due to peritonitis or intestinal obstruction. 47% patients responded adequately to anti tubercular therapy. In 20%, procedural complications were seen. Diagnosis of abdominal tuberculosis can be made on clinical grounds complications of abdominal tuberculosis can be averted with early commencement of drug therapy. Ileostomy is life saving procedure in malnourished patients. Leaving wound open for delayed primary closure not only allows continuous inspection of parties but also helps easy drainage of abscess if pus accumulates subsequent to surgical intervention or overlooked perforation