Role of surgery and laparoscopy in management of abdominal tuberculosis

ABSTRACT

Tuberculosis [TB] considered as the most communicable disease world wid. Among extra pulmonary TB the prevalence of abdominal TB shows rising tendency. Abdominal TB is defined as an infection of one or more common of two or more of the following sites; peritoneum, mesentery, gastrointestinal tract and or solid organs. Reported incidence of abdominal TB varies from country to country. The most common clinical features are abdominal pain, fever and weight loss. To evaluate the role of surgery in the management of abdominal TB especially with the advent of minimal access surgery [laparoscopy] in the diagnosis of this disease. Prospective study was conducted in Al-Kadhymia Teaching Hospital over three years [2007-2010], fifty six patients with abdominal TB were included, the patients were managed by full surgical and or medical teams, results was analyzed by appropriate statistical measures. Most patients were in the 2[nd], 3[rd] and 4[th] decades of life. Female to male ratio was 1.51. Most of the patients [82%] considered to have primary abdominal TB. Diagnostic laparoscopy was done for 21 patients and proved TB in 19 patients. Explorative laparotomy was done in 19 patients, the commonest operative finding was ascites and peritoneal tubercles. Abdominal TB should be considered in all patients who presented with unexplained abdominal symptoms and signs. Laparoscopy is an effective modality for diagnosis of abdominal TB