Perforated tubercular enteritis of childhood: A ten year study (original) (raw)
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Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND In acute abdomen, the difference between the best and worst surgery is infinitely less than between early and late surgery and the greatest sacrifice of all is sacrifice of time. The aim of the present work is to find out the epidemiology of the gastrointestinal perforation in children and incidence of aetiology in such perforations and the result of different surgical procedure and management performed. MATERIALS AND METHODS A prospective and retrospective study was conducted in Mahatma Gandhi Memorial Medical College and MY Hospital over a period of 5 years from Jan. 2013 to Oct. 2017. A total of 106 patients presented in this period with hollow viscus perforation and out of these 59 patients were retrospective and 47 were prospective. In our study, the main diagnostic tools were history, clinical examination, scout film abdomen and operative findings. The different GI perforations were labelled under the aetiologies as enteric, idiopathic, unknown, appendicular, tubercular and miscellaneous perforation. RESULTS A total of 106 patients with gastrointestinal perforation were included in the study. The causes for perforation were traumatic (19.23%), idiopathic (15.38%) and enteric (15.38%). CONCLUSION The common pathology of gastrointestinal perforation is traumatic, idiopathic and enteric fever. N. mortality is 29%. Hence, the need of the day is correct recognition at the earliest opportunity of the case of perforation peritonitis, an extensive medical management and timely judgement for surgical intervention.
A case of tuberculous peritonitis in childhood
Journal of Infection and Public Health, 2015
Currently, tuberculosis remains a major public health problem worldwide. Peritoneal tuberculosis occurs in approximately 1% of all of tuberculosis cases and is rarely observed in children. Diagnosis and treatment delays caused by mimicking many other intra-abdominal diseases can lead to increases in morbidity and mortality. Here, we present a case of a four-year-old child with tuberculosis peritonitis who was diagnosed by laparoscopic biopsy and histopathological examination and recovered with antituberculosis therapy. Peritoneal tuberculosis should be considered in younger patients and adults with fever, abdominal pain and weight loss in endemic areas.
Tuberculous Intestinal Perforation : A Nightmare for the Surgeons
2010
Introduction: The incidence of abdominal tuberculosis has been steadily increasing over the past 20 years. The situation is worse in underdeveloped countries like Pakistan where poverty, overcrowding, unhygienic environment & recent outbreaks of multidrug resistant tuberculosis (MDR-TB) have posed more challenges for the management of abdominal tuberculosis. Tuberculous intestinal perforation is an even bigger challenge for the surgeons. Objectives: To reduce the morbidity and mortality related to tuberculous intestinal perforation vide application of Modified New Scoring system based upon simple pre-operative & intraoperative criterias. Patients and Methods: This descriptive study was conducted at surgical ward II, SZMC/Hospital, Rahimyar Khan, from 1st March 2009 to 31st August 2010 and 13 patients of tuberculous intestinal perforation were included in this study. Based on Modified New Scoring system, patients were divided into three groups. Group I were managed with primary closu...
Pakistan Journal of Medical Sciences
Objective: To evaluate clinical presentation and surgical outcome in children with enteric perforation. Methods: A descriptive retrospective study was conducted in Department of Paediatric Surgery at National Institute of Child Health, Karachi from August 2016 and September 2019, in children 12 years of age and under with diagnosis of enteric perforation. Data about age, gender, duration of illness, hemodynamic status and baseline investigation on admission was reviewed. Details about patients operated early and those who required prolong resuscitation and were operated after 24 hours of admission, need for tube laparostomy, operative findings, type of surgical procedure performed and post-operative outcome were reviewed. Data was analyzed using SPSS version 22. Results: Ninety-seven patients, 60(61.85%) males and 37(38.14%) females were managed during the study period with age ranged from 3-12 years (mean 7.82, ± 2.94 years).and duration of symptoms ranged from 7-30 days (mean 15.5...
Tuberculous peritonitis in an endemic area
Digestive and Liver Disease, 2003
Aims. To identify the clinical, laboratory, and diagnostic features of tuberculous peritonitis in Iranian patients. Patients. Included in the study were all cases of tuberculous peritonitis with a definite diagnosis confirmed by pathology in four referral University Hospitals in Tehran between 1989 and 1999.
Pattern of ileal perforation in our experience; a tertiary care centre in Eastern India
International Surgery Journal, 2018
Advanced medical facilities have changed the etiological patterns of non-traumatic ileal perforation but still nontraumatic perforation is commoner than traumatic perforation in developing countries. But in western countries the typhoid and tuberculous perforation is rare. In developed countries most common aetiology remains vascular strangulation, foreign bodies ingestion, ABSTRACT Background: Perforation peritonitis is one of the common acute abdomen admitted in emergency department for emergency laparotomy. Pattern and aetiology of ileal perforation varies from developed and developing countries where infectious diseases are still highly prevalent. Methods: This was a prospective study conducted over 3 years period in Indira Gandhi Institute of Medical Sciences, Patna. Total 118 patients were enrolled for this study after confirmation of ileal perforation on exploratory laparotomy. Results: Out of total 118 patients 52 cases (44%) were in traumatic, typhoid causes perforation in 86% (57 cases) tuberculosis in 14% (9 cases) and 66 cases (56%) were in non-traumatic group, penetrating injury is more common than blunt trauma abdomen. Males are more commonly affected than females in among all cases of ileal perforation. Patients with traumatic ileal perforation seek early medical attention as most of the patients (44%) admitted within 12 hours after accident where as in case of non-traumatic cases 53% patients admitted after 2 days. Most common operative procedure performed is Loop ileostomy in case of non-traumatic perforation (49%) and Resection and anastomosis preferred in traumatic perforation (63%). Mortality rate is about 20% in all types of perforation. Conclusions: In developing countries like India typhoid perforation is still most common cause of ileal perforation. Loop ileostomy is more preferred procedure in infectious cases but resection and anastomosis in case of traumatic perforation in our institute.
Surgical Management of Suspected Enteric Ileal Perforations in Children
Journal of Surgery Pakistan ( …, 2011
INTRODUCTION: Enteric fever is still prevalent in underdeveloped countries. Children are not an uncommon victim of this condition.1,2 Enteric fever is a medical condition but it is feared with dreadful surgical complication, ... Correspondence: Dr. Jamshed Akhtar Department of ...
Journal of Evolution of Medical and Dental Sciences, 2016
Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. It is reported to constitute the fifth common cause of abdominal emergencies due to high incidence of enteric fever and tuberculosis in these regions. METHODS This study included 94 patients diagnosed with ileal perforation, admitted and treated in the Department of General Surgery from February 2011 to January 2012 in an Educational Institute of Central India. RESULT Out of the 94 patients studied, 72 (76.59%) were males and 22 (23.4%) were females; 8 patients had hypertension, 6 patients had diabetes and 8 patients both HT and DM; 48 patients were diagnosed to have typhoid fever and received antibiotics prior to hospitalization for perforation; 7 patients were taking ATT from DOT'S centre. All the 11 patients who died had symptoms for more than 24 hours. Seven of the 83 survivors had symptoms for more than five days. The surgical intervention was initiated within the first 24 hours of admission in 68 (72.34%) of the patients. The overall mortality rate was 11.7% (11 patients). CONCLUSION Early recognition, timely surgical intervention, appropriate antibiotics and surgical technique, pre-operative, post and perioperative care play a key role in reducing mortality in ileal perforation.
Perforation Peritonitis and the Developing World
ISRN Surgery, 2014
Background. Perforation peritonitis is the one of the commonest emergency encountered by surgeons. The aim of this paper is to provide an overview of the spectrum of perforation peritonitis managed in a single unit of a tertiary care hospital in Delhi. Methods. A retrospective study was carried out between May 2010 and June 2013 in a single unit of the department of Surgery, Lok Nayak Hospital, Delhi. It included 400 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included. Results. The commonest cause of perforation peritonitis included 179 cases of peptic ulcer disease (150 duodenal ulcers and 29 gastric ulcers) followed by appendicitis (74 cases), typhoid fever (48 cases), tuberculosis (40 cases), and trauma (31). The overall mortality was 7%. Co...
International Surgery Journal
Background: Gastrointestinal perforation is one of the common surgical emergencies in developing countries. The diagnosis is mainly clinical and is aided by radiological investigations. This study was designed to highlight the spectrum of hollow viscus perforation peritonitis in terms of etiology, clinical presentations, site of perforation, surgical treatment, postoperative complications, and mortality.Methods: The study was a hospital‑based observational study and included 462 patients of perforation peritonitis (diffuse or localized) who were studied retrospectively in terms of cause, site of perforation, surgical treatment, complications, and mortality. Only those patients who underwent exploratory laparotomy for management of perforation peritonitis were included.Results: Overall stomach was the most common site of perforation (33%). Ileum (26%) was the second common site of perforation. Duodenal perforations were seen in 88 (19%) cases whereas appendicular perforations were se...