Abdominal tuberculosis: a varied presentation

ABSTRACT

Abdominal Tuberculosis presents to the general surgeon in one of the three forms 1, intestinal obstruction 2, tuberculous peritonitis 3, abdominal mass. In this report, patients presenting with intestinal obstruction [Acute or sub acute], over a two year period at the Department of General Surgery, Shaikh Zayed Hospital, Lahore, 30 cases were found to have intestinal tuberculosis out of a total 100 cases studied. All patients were diagnosed on exploration with hisopathological evidence of tuberculosis and/or demonstration of A.F.B. in the lesion. The mean age was 34.9 years, male to female ratio 2 1. 86% of the patients had primary intestinal tuberculosis whereas 14% were considered to be suffering from secondary intestinal tuberculosis. Majority of the patients [66%], had single multiple strictures involving the triminal ileum and ileocaecal region, 20% of the patients were found to have mass in the ileocaecal region and perforation was seen in 14% of the cases. Primary resection of the tuberculous lesion was carried out in 28 patients. Stricturoplasty was performed in the remaining 2 patients. Hospital mortality was zero and major post operative complications were noted in 8% of the cases. The patients received standard anti-tuberculosis treatment for a period of 12 months, follow up record was available on only 26 patients. All 26 patients had completed the anti-tuberculosis medication without any ill effects. No patient had presented with recurrent problem of obstruction