Abdominal Tuberculosis Presenting With Small Bowel Obstruction: A Case Report (original) (raw)
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Intestinal Tuberculosis; Pattern of Presentation and Surgical Management
THE PROFESSIONAL MEDICAL JOURNAL, 2016
Tuberculosis is one of the leading causes of morbidity and mortality, responsible for annual 7-10 million new cases and 6 per cent of deaths in developing countries. It can involve any part of abdomen but most common is intestinal tract in which it can present with wide variety of symptoms. Early diagnosis and appropriate management is challenging for clinicians. Objectives: To determine the modes of presentation of abdominal tuberculosis and effectiveness of surgical procedures in our setup. Study Design: A retrospective study. Setting: Surgical unit-I of Holy Family Hospital, Rawalpindi. Period: January 2014 to December 2014. Materials and Methods: 50 patients with abdominal tuberculosis were included in the study. Histopathology confirmed the diagnosis of abdominal tuberculosis. Age, gender, mode of presentation, evidence of co-existing tuberculosis, family history, drug history of antituberculous treatment, laboratory and radiological investigations, treatment modalities and duration of hospital stay were recorded. Results: There were 28 female (56%) and 22 male (44%) patients with a mean age of 29± 10.23 years. 56% patients presented with subacute intestinal obstruction, 16% with acute intestinal obstruction and 14% with peritonitis. All 50 patients underwent laparotomy. Ileocecal mass with perforation (40%) was seen as the most common per-operative finding. Limited right hemicolectomy with ileocolostomy (44%) was performed in most of the cases. Mean length of hospital stay was 10 ± 4.67 days. Conclusion: Abdominal tuberculosis is a common cause of acute abdomen especially intestinal obstruction in our setup, with a variable mode of presentation. Early diagnosis with appropriate surgical management and chemotherapy can prevent significant morbidity and mortality.
Bowel obstruction due to tuberculosis band: A case report and review of the literature
Archives of Clinical Gastroenterology
Peritoneal tuberculosis accounts for 0.1-0.7% of all tuberculosis patients, the clinical signs are non-specifi c apart from a complication; The incidence of intestinal obstruction due to tuberculosis bands from 12% to 60%. Tuberculosis can affect any part of the body, but the abdomen is one of the most common sites after the lungs, The clinical presentation of abdominal tuberculosis is usually nonspecifi c and, therefore, often leads to a delay in diagnosis and thus the development of complications such as intestinal obstruction, Imaging plays an important role in the positive diagnosis of the occlusion. We report the case of a 61-year-old patient with no particular pathological history admitted to the emergency room with a bowel obstruction syndrome which the surgical exploration found a bowel obstruction on a primary tuberculosis band.
A clinical dilemma: abdominal tuberculosis
To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests, M a n t o u x s k i n t e s t , c h e s t X -ray a n d a b d o m i n a l ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed.
Intestinal obstruction due to tuberculosis
Asian journal of surgery / Asian Surgical Association, 2002
OBJECTIVES: Intestinal obstruction due to tuberculosis is a rare form of mechanical bowel obstruction. The objectives of this study were to determine the clinical features, to evaluate the role of surgery and to choose procedures in management of this disease. METHODS: In this 7-year retrospective study (from 1992 to 1998), 23 patients (20 males, three females) were included, accounting for 4.5% of all mechanical intestinal obstructions. More than 80% of the patients had a clinical picture of lower small bowel obstruction, while 90.5% of patients had advanced pulmonary tuberculosis. RESULTS: In 54.6% of cases, obstruction occurred in the ileocaecal region. The main lesion causing obstruction was intestinal tuberculosis in the hypertrophic form (86.4%). Diagnosis of intestinal tuberculosis as a cause of obstruction was not easy because it has no specific symptoms and signs. CONCLUSION: In terms of management, ileocolostomy was often used (68.2%) but long-term results were not very good. Blind loop syndrome was one of its disadvantages. Resection may be the safe and effective procedure. (Asian J Surg 2002:25(2):145-8)
ABDOMINAL TUBERCULOSIS (STUDY OF 50 CASES
International Journal of surgery and Medicine, 2022
Background: The incidence of abdominal tuberculosis is increasing. Preoperative diagnosis continues to be the biggest challenge. Diagnosis is established only after histopathological examination. The modes of presentation and therapeutic options need to be assessed. Objectives: To study the patterns of presentations, the extent of organ involvement and therapeutic options. Materials and methods: Fifty histopathologically proven cases of abdominal tuberculosis were studied. In addition, epidemiologic data, clinical patterns of presentation, diagnostic and various surgical options, including outcomes, were studied. Results: The mortality in the study was 8%. The disease was commonly seen in 21 to 40 years old and commonly seen in females. HIV positivity, anaemia and hypoproteinaemia were associated with poor outcomes. Four types of presentations were observed. Diagnostic laparoscopy enabled early histopathological diagnosis of biopsy specimens. Chemotherapy is the mainstay of treatment Surgery is a significant adjunct in diagnosing and managing complications. Patients presenting with perforative peritonitis had a poor prognosis Conclusion: Critical evaluation of chronic abdominal pain is essential. Supportive evidence such as the history of TB or contact with a patient suffering from TB is highly suggestive of abdominal tuberculosis. Radiological tests are highly suggestive but not diagnostic. Diagnostic laparoscopy enables tissue diagnosis. Chemotherapy accompanied by surgical intervention for complications is the mainstay of treatment.
Tuberculosis is one of the earliest diseases affecting the mankind. Abdominal tuberculosis constitutes a common public health issue in developing countries like ours. Gastrointestinal tuberculosis often involves the ileo-caecal region. Surgery in case of abdominal tuberculosis is required to overcome the deleterious effects of the disease like tissue disorganization, obstruction and perforation.Aims And Objectives: 1. To study the various clinical profiles of gastrointestinal tuberculosis in patients undergoing laparotomy;2. To study the surgical pathology of gastrointestinal tuberculosis; 3. To study the various surgical treatment modalities based upon the intraoperative findings and its outcome. Results: This is a prospective study over 12 months at Government Medical College & Hospital Amritsar, Punjab. This study was done to study the clinic-pathological profile of gastrointestinal tuberculosis undergoing laparotomy. Incidence of gastro intestinal tuberculosis was seen highest in age group 15 to 25 years with male predominance. Most common presentation being intestinal obstruction with ileo-caecal as the most common area involved and right hemicolectomy as the commonest procedure done. Common surgical pathologies were ileo-caecal mass and ileal perforation and this also has relation to pulmonary tuberculosis.Conclusion: Inspite of specific antituberculous drugs and vast measures against the disease, including chemoprophylaxis and pasteurization, abdominal tuberculosis remains a fairly common disease even today. Gastrointestinal tuberculosis has an indolent course and the common mode of presentation is usually sub acute or chronic intestinal obstruction. Prompt surgical exploration, vigilant postoperative care and administration of ATT helped to treat the patients successfully with their complete cure and rehabilitation.
Abdominal Tuberculosis: Epidemiologic Profile and Management Experience of 233 Cases
Jpma the Journal of the Pakistan Medical Association, 2012
OBJECTIVE: To document the epidemiologic profile and management outcome of patients with abdominal tuberculosis in a tertiary care setup.METHODS: This descriptive case series was conducted at the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, between January 2003 and December 2008. All adult patients of either gender who presented with abdominal tuberculosis and were managed at our hospital during the study period were included in the study on the basis of convenience sampling. Numerical data were expressed as mean +/- standard deviation, while categorical data were analysed using SPSS version 10. Chi square test was conducted to compare categorical variables.RESULTS: Of the 233 adult patients with abdominal tuberculosis who were part of the study, 110 (47.21%) were males and 123 (52.78%) females. The mean age was 28.21 +/- 5.75 years. Majority of our patients (80.68%) belonged to poor families. History of concomitant pulmonary tuberculosis was found in 23 (9.87%) patients. Family history of tuberculosis was found in 13 (5.57%) patients. Of the patients 157 (67.38%) presented with acute abdomen; strictures were the most common operative finding (n = 161; 69%); the patients needing hospitalisation were 204 (87.55%), with the mean hospital stay being 19.55 +/- 4.51 days. The in-hospital mortality was 5 (2.14%).CONCLUSION: Abdominal tuberculosis was found prevalent in the population and predominantly affected the younger lot belonging to the poor socioeconomic strata. Majority of the cases were of primary intestinal variety, and in a small proportion it was secondary to pulmonary tuberculosis. Majority of the patients presented with complications such as acute intestinal obstruction, intestinal perforation and peritonitis, necessitating emergency laparotomy.