Abdominal tuberculosis: a surgical emergency

Authors

  • Rajandeep Singh Bali Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
  • Rahul Jain Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
  • Yawar Zahoor Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
  • Ankul Mittal Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20173641

Keywords:

Abdominal tuberculosis, No standardised management protocol, Varied presentation

Abstract

Background: To study and assess the clinico-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality of the patients included in the study group.

Methods: This study was carried out at Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, a tertiary care hospital between November 2011 to March 2015. It was a retrospective study in which the records of the patients operated upon in the emergency department as peritonitis or acute intestinal obstruction and whose diagnosis was later confirmed as tuberculosis on histopathology were analysed with regards clinic-pathologic profile, intra-operative findings, surgical intervention performed and outcome in terms of morbidity and mortality.

Results: The mean age of our study group was 28.7 years. 70% of our patients were found to be in the underweight category and 30% were in the normal category. Fourty three (56.6%) presented to the hospital with features suggestive of peritonitis and thirty-three (43.4) were suffering from acute intestinal obstruction. The commonest intra-operative finding encountered was ileal perforation followed by multiple small bowel perforations, solitary stricture of the small bowel with perforation, ileo-cecal mass, adhesions or bands, single or multiple strictures, stricture with impending small bowel perforation and jejunal perforation. The frequently performed surgical procedures were ilesotomy, resection and anastamosis of the involved bowel, primary repair of thr perforation, right hemicolectomy, adhesiolysis, stricturoplasty (done in case of single stricture, mostly), jejunostomy and peritoneal and omental biopsy.

Conclusions: Tuberculosis is a very grave disease, studies with larger number of patients need to be conducted to standardise its surgical management as at present there is no standardised surgical management protocol.

Author Biography

Rahul Jain, Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India

General Surgery

Maulana Azad Medical College & Lok Nayak Hospital

New Delhi

References

Addison NV. Abdominal tuberculosis-a disease revived. Ann R Coll Surg Engl. 1983;65:105-11.

Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88:989-99.

Aston NO. Abdominal tuberculosis. World J Surg. 1997;21:492-9.

Lonnroth K, Raviglion M. Global epidemiology of tuberculosis: Prospects for control. Semin Respir Crit Care Med. 2008;29:481-4.

Mehmood N, Najam S, Yunus M. Analysis of presentation of cutaneous tuberculosis in surgical department. JIIMC. 2008;1(1):23-30.

Rao KVV, Rao KS. Surgical study of abdominal tuberculosis. IOSR-JDMS. 2016;15(6):32-5.

Skopin MS, Batyrov FA, Kornilova Z. The prevalence of abdominal tuberculosis and the specific features of its detection. Probl Tuberk Bolezn Legk. 2007;1:22-6.

Khan IA, Khattak IU, Asif S, Nasir M, Ziaur R. Abdominal tuberculosis an experience at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad. 2008;20:115-8.

Baloch NA, Baloch MA, Baloch FA. A study of 86 cases of abdominal tuberculosis. J Surg Pak. 2008;13:30-2.

Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J Med Res. 200;120:305-15.

Mohammed A. Clinical profile and surgical outcome of abdominal tuberculosis-a retrospective analysis. Int J Med Health Sci. 2013;2:402-6.

Gondal KM, Khan AFA. Changing pattern of abdominal tuberculosis. Pak J Surg. 1995;11:109-13.

Charokar K, Garg N, Jain AK. Surgical management of abdominal tuberculosis: a retrospective study from Central India. Int Surg J. 2016;3(1):23-31.

Jaskani S, Mehmood N, Khan NM. Surgical management of acute presentation and outcome of patients with complicated abdominal tuberculosis. J Rawalpindi Med Coll (JRMC). 2016;20(2):108-12.

Ali N, Hussein M, Israr M. Tuberculosis as a cause of small bowel obstruction in adults. Gomal J Med Sci. 2011;9:233-5.

Sabooni K, Khosravi MH, Pirmohammad H. Tuberculosis peritonitis with features of acute abdomen in HIV infection. Int J Mycobacteriol. 2015:02:04:151-3.

Chalya PL, Mchembe MD, Mshana SE. Clinicopathological profile and surgical treatment of abdominal tuberculosis: a single centre experience in north western Tanzania. BMC Infect Dis. 2013;13:270-3.

Downloads

Published

2017-08-26

How to Cite

Bali, R. S., Jain, R., Zahoor, Y., & Mittal, A. (2017). Abdominal tuberculosis: a surgical emergency. International Journal of Research in Medical Sciences, 5(9), 3847–3850. https://doi.org/10.18203/2320-6012.ijrms20173641

Issue

Section

Original Research Articles