Prospective study of emergency presentation of abdominal tuberculosis
Background: In developing countries like India, where poverty, malnutrition and overcrowding prevail, tuberculosis continues to be one of the important causes of morbidity, mortality and loss of working man hours. Abdominal tuberculosis (TB) can affect the gastrointestinal tract, the peritone...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
BKL Walawalkar Rural Medical College & Hospital
2016-08-01
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| Series: | Walawalkar International Medical Journal |
| Subjects: | |
| Online Access: | http://www.wimjournal.com/html/journal/images/3a3.pdf |
| Summary: | Background:
In developing countries like India, where
poverty, malnutrition and overcrowding
prevail, tuberculosis continues to be one of the
important causes of morbidity, mortality and
loss of working man hours. Abdominal
tuberculosis (TB) can affect the
gastrointestinal tract, the peritoneum, lymph
nodes of the small bowel mesentery or the
solid viscera (e.g. liver, spleen, pancreas etc)
Patient of abdominal Koch’s can present as
those with a chronic undulating course and
those with an acute or subacute abdominal
catastrophe. In emergency the patient may
present with various presentations like
stricture causing obstruction or with
perforation and require a different
management from those routine such cases
Aim and Objective:
To study the varied presentation of patients
with Abdominal Tuberculosis as acute
surgical abdomen presenting in emergency
setting to those with a subacute course.
To evaluate the line of management whether
operative or conservative, the operative details, post operative course and the final
outcome of the disease.
To study the incidence of HIV positivity in
patients with abdominal tuberculosis.
Methods and material:
The study was designed as a prospective
observational study conducted during a study
period between June 2006 and June 2008 in a
tertiary care centre in Mumbai. All patients
with a clinical suspicion of abdominal
tuberculosis were included in the study with
confirmation on histopathological
examination. Patient’s written informed valid
consent was taken after explaining the nature
of study.
Result and Conclusion:
Age group commonly affected was
between 21-30 years with male predominance.
Amongst the various complications of
abdominal tuberculosis intestinal obstruction
was the most common mainly due to stricture
and less commonly due to hyperplastic
ileocaecal mass. Next common complication
observed was free perforation of the intestine
which occurs at a site proximal to a tight
stricture. All patients were subjected to operative intervention with local resection and
anastomosis being the most preferred surgery
performed. Terminal ileum and ileocaecal
region was the most common site involved.
The incidence of HIV positivity was 11 per
cent. The incidence of mortality was 11 per
cent. Sepsis was the main cause of mortality in
all the cases. Duration of stay ranged from 2 to
60 days. A prolonged stay was seen in patients
who developed post operative complications. |
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| ISSN: | 2349-2910 2395-0684 |