Experience with surgical management of intestinal tuberculosis at a rural teaching hospital

Authors

  • Mohammed Shamim Ali Department of General Surgery, Katihar Medical College, Katihar, Bihar
  • Prince Pankaj Department of General Surgery, Katihar Medical College, Katihar, Bihar
  • Deepak Pankaj Department of General Surgery, Katihar Medical College, Katihar, Bihar
  • Sweta Muni Department of Microbiology, Katihar Medical College, Katihar, Bihar

DOI:

https://doi.org/10.18203/2320-6012.ijrms20160329

Keywords:

Abdominal tuberculosis, Distention, Intestinal, Obstruction, Perforation

Abstract

Background: Tuberculosis is a major global health problem and still considered as a social disease in India reflecting the standards of living in a community. It possesses a diagnostic and therapeutic challenge to practicing surgeon in resource limited contries. The aim of the present study was to study different surgical management of Intestinal tuberculosis.

Methods: 100 cases of intestinal tuberculosis were studied over a period of three years in the department of General Surgery at Katihar Medical College with emphasis on surgical management of these cases.

Results: 64% of the cases were in the age group of 21-40 years. The sex incidence revealed a female to male ratio of 1.17:1 showing a female preponderance. Low haemoglobin value and high erythrocyte sedimentation rate with lymphocytosis were present in majority of the cases. Radiological finding in plain X ray abdomen was of definite diagnostic aid in cases of intestinal obstruction and perforation. On laparotomy, diagnosis was supported by presence of tubercles, macroscopic caseation, enlarged and calcified lymph glands, bands, adhesion and strictures. The commonest site involved was small bowel followed by the ileocaecal region. The commonest type of lesion was stricture, which mostly involved the small bowel followed by hyperplastic lesions which were more common in caecum and ascending colon. Acute complications of the disease were perforation and obstruction, which forced the patients to undergo emergency surgical treatment. Wound infection (30%) was the most common complication.

Conclusions: Multidisciplinary approach with high index of suspicion for the disease is required in these cases. Mostly a disease of low socio - economic people, health education and awareness among people is the need as this disease is very prevalent in this region.

 

References

Rosado E, Penha D, Paixao P, Costa AMD, Amadora PT. Abdominal tuberculosis - Imaging fidings. Educational exhibit; ECR. 2013:C-0549.

World Health Organization. Global tuberculosis report 2013. Geneva: WHO. 2013. Available from: URL:http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf

Pop M, Pop C, Homorodean D, Itu C, Man M, Goron M, et al. Abdominal miliary tuberculosis in a patient with AIDS: a case report. Rom J Gastroenterol. 2003;12:231-4.

Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J Med Res. 2004;120:305-15

Rajpoot MJ, Memon AS, Rani S, Memon AH. Clinicopathological profile and surgical management outcomes in patients suffering from intestinal tuberculosis. J Liaqaut Uni Med Health Sci. 2005;4:113-8.

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

Shaikh MS, Dholia KR, Jalbani MA. Prevalence of intestinal tuberculosis in cases of acute abdomen. Pakistan J Surg. 2007;23:52-6.

Anuradha B, Aparan S, Hari SPV, Vijaya LV, Akbar Y, Suman LG. Prevalence of drug resistance under the DOTs Strategy in Hyderabad South India, 2001 –2003. Int J Tuberc Lung Dis. 2006;10:58-62.

Butt T, Karamat KA, Ahmad RN, Mahmood A. Advances in diagnosis of tuberculosis. Pak J Pathol. 2001;12:1-3.

Khan SM, Khan KM, Khan AS, Jehanzeb M, Jan WA, Khan M, et al. Presentation of abdominal tuberculosis in NWFP and its correlation with operative findings. J Postgrad Med Inst. 2005;19:286-91.

Gondal SH, Gulshan S, Naseeb U. Intestinal Tuberculosis as an abdominal emergency. Pak Postgrad Med J. 2000;11:103-5.

Zafar A, Qureshi AM, Iqbal M. Comparison between Strictureplasty and Resection Anastomosis in Tuberculous Intestinal Strictures. J Coll Physicians Surg Pak. 2003;13:277-9.

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

Homan WP, Grofe WR, Dineem P. A 44-year experience with tuberculous enterocolitis. World J Surg. 1977;2:45-50.

Wig KL, Chitkara NL, Gupta SP, Kishore K, Manchanda RL. Ileocaecal Tuberculosis with particular referenceto isolation of Mycobacterium tuberculosis. Am. Rev. Respir. Dis. 1961;84:169-78.

Segal I, Tim LO, Mirwis j, Hamilton DG, Mannell A. Pitfalls in diagnosis of gastrointestinal tuberculosis. Am J Gastroenterol. 1981;75(1):30-5.

Lambrianides AL, Ackroyd N, Shorey BA. Abdominal tuberculosis. Br J Surg. 1980;67(12):887-9.

Manohar A, Simjee AE, Haffejee AA, Pettengell KE. Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period. Jr Gut. 1990;31:1130-2.

Chandra A, Basu AK. Cicatrizing lesions of the ileocaecal lesion. Ind. J. Surg. 1967;29:645.

Bhansali SK. Abdominal tuberculosis. A study of 300 cases. Am. J. Gastro. 1977;67:324.

Prakash A. International tuberculosis 18 years review. Ind Med Jour. 1978;40:56-64.

Sharma R. Abdominal Tuberculosis. Imaging Science Today. 2009:146.

Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R. Clinical, colonoscopic, and histological profie of colonic tuberculosis in a tertiary hospital. Endoscopy. 2005;37:351-6.

Das HS, Rathi P, Sawant P, Chodankar CM, Vyas K, Patrawala V, et al. Colonic tuberculosis: colonoscopic appearance and clinico-pathologic analysis. J Assoc Physicians India. 2000;48:708-10.

Chen WS, Leu SY, Hsu H, Lin JK, Lin TC. Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis. Dis Colon Rectum. 1992;35(2):189-92.

Downloads

Published

2016-12-25

How to Cite

Ali, M. S., Pankaj, P., Pankaj, D., & Muni, S. (2016). Experience with surgical management of intestinal tuberculosis at a rural teaching hospital. International Journal of Research in Medical Sciences, 4(2), 633–638. https://doi.org/10.18203/2320-6012.ijrms20160329

Issue

Section

Original Research Articles