Presentation and Management of Abdominal Tuberculosis: Experience of the Department of Surgery, Lady Reading Hospital Peshawar
Keywords:
Abdominal tuberculosis, Surgical management, Histopathology.Abstract
Background: Current study aims to determine the frequency of abdominal tuberculosis and to evaluate the current surgical treatment strategies and itsoutcome.
Methods: This prospective observational case series study was conducted in Medical Teaching
Institute (MTI) surgical department of the Lady Reading Hospital Peshawar from January 2015 to January 2016. In this study a total of 40 patients of abdominal tuberculosis were admitted in surgical department through emergency and outpatient department. All the patients underwent surgery, 75% in the casualty and 25% as elective cases. Detailed history was taken from all patients and surgery was performed. Diagnosis of abdominal tuberculosis was established on histological basis. Data was entered and analyzed in SPSS.
Results: Thirty (75%) patients were admitted through casualty as acute emergency, 10 (25%) through OPD. Mean age of the patients was 32.3 years (range = 15-70 years). Most commonly affected age group was 20-29 years. Male to female ratio was 1.1:1. Among total 40 patients, 25 (62.5%) patients had intestinal tuberculosis while 14 (35%) patients had tuberculous peritonitis and 1 (2.5%) patient had isolated lymph node involvement. Histological examination showed typical tuberculous granulomas with caseation in most of involved tissues.
Conclusion: Abdominal tuberculosis is still one of the most common cause for acute/sub-acute abdomen. Diagnosis can be frequently delayed if index of suspicion is low. Neglected undiagnosed cases frequently present with consequences like intestinal perforation and advanced obstruction. Furthermore, vigorous resuscitation in the preoperative period is vital for a favorable outcome.
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