Primary abdominal tuberculosis presenting as peritonitis in a young child–managed surgically (original) (raw)

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.

CASE REPORT: ACUTE ABDOMEN WITH PERFORATION DUE TO INTESTINAL TUBERCULOSIS (Atena Editora)

CASE REPORT: ACUTE ABDOMEN WITH PERFORATION DUE TO INTESTINAL TUBERCULOSIS (Atena Editora), 2024

Introduction: Tuberculosis is one of the infectious diseases that kills the most in the world, being surpassed in 2020 by Covid-19. It is estimated that in 2020 tuberculosis was responsible for 1.3 million deaths worldwide in people without HIV with 10 million new infections per year. This article will report a case of a rare case of intestinal perforation secondary to tuberculosis. Objectives: Report the case of an acute abdomen with perforation due to intestinal tuberculosis. Methods: This is a case report and is an observational, descriptive and retrospective study. The data were obtained from medical records and exams carried out on the patient diagnosed with Intestinal Tuberculosis, the main cause of Intestinal Perforation at Hospital Geral Dr. Waldemar Alcântara in the Adult ICU. Discussion: An Intestinal tuberculosis is one of the forms of extrapulmonary tuberculosis that is difficult to diagnose as it does not present characteristic symptoms. Generally, cases present with intestinal obstruction, with intestinal perforation being rarer. Final Considerations: The patient had an unfavorable outcome, despite the diagnosis and treatment having been initiated, due to other complications related to hospitalization he died.

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.

A Rare Case of Peritoneal Tuberculosis in a 21 Years Old Male Patient

Journal of Surgery Research and Practice, 2022

Tuberculosis is among the top 5 causes of death from infectious disease caused by Mycobacterium tuberculosis, it most frequently affects the lungs, although it can compromise the digestive tract, genitourinary, peritoneum, pleura, bones, lymph nodes and meninges, composing the group of extrapulmonary tuberculosis. Peritoneal involvement is the most common form of abdominal type representing 0.1 to 0.7% of all tuberculosis cases. With nonspecific symptoms, without of laboratory findings that would guide the search for Mycobacteria and imaging tests that overlap common in other pathologies, the diagnosis is difficult. In Abdominal Computed Tomography, ascites, smooth peritoneal thickening, densification of the mesentery root, lymphadenomegaly with central necrosis or calcification are observed. Laparoscopy with the biopsy and collection of ascitic fluid is used as a method for diagnosis. The mortality of abdominal tuberculosis can reach 15% and perforation of intestinal loops, malnutrition, anemia, hypoalbuminemia are the main complications. We present the case of a patient presenting recurrent umbilical hernia, whose diagnosis of peritoneal tuberculosis was made during surgery.

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.

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.

Abdominal Tuberculosis - Profile of 26 Cases

All patients with abdominal tuberculosis, who had varied modes of presentations, were included. Diagnosis was based on history, physical examination and laboratory investigations. Patients who underwent surgery their preoperative findings and procedure performed was also recorded. Results: Mean age of 10 male and 16 female patients was 33 years (range 14-66 years). Varied presentation of abdominal tuberculosis included pain in abdomen (88.46%), fever (84.6%), weight loss (69.2%), mass in abdomen (46.1%) and abdominal distention Ascites) (26.9%). Surgical intervention was done in 16 (61.5%), mass in abdomen. Adhesiolysis (18.75%), resection and anastamosis (12.5%), stricturoplasty (12.5%). loop Ileostomy (25%), closure of perforation (18.75%) and limited right hemicolectomy (12.5%) were the procedures carried out. 4 patients expired with a mortality rate of 25%. Conclusion: The diagnosis of abdominal is difficult due to the lack of specific signs and symptoms. However predetermined clinical can be readily applied for earlier diagnosis. Surgical exploration is reserved for equivocal cases and for those who present as emergencies.

Perforated Intestinal Tuberculosis in a Non-AIDS Immunocompromised Patient

The American journal of case reports, 2015

BACKGROUND Intestinal tuberculosis can mimic many conditions. The incidence of intestinal tuberculosis in developed countries has risen in tandem with the increase in patients with immunocompromised states. This is a condition which needs to be considered in patients who present with symptoms and signs of bowel perforation on a background of immunosuppression in order to obtain the correct diagnosis and, consequently, the correct treatment. CASE REPORT We report a patient with a background of sarcoidosis who had been on mycophenolate mofetil, tacrolimus, and high-dose prednisolone. He presented with abdominal pain without overt peritonitis. Initial imaging showed small locules of free air in the abdominal cavity. The patient was managed with intravenous antibiotics as upfront surgery was deemed to be high risk. However, on a repeat imaging scan 3 days later, larger locules of gas were seen within the abdominal cavity, indicating progression and non-resolution of his acute condition....

Abdominal Tuberculosis Presenting With Small Bowel Obstruction: A Case Report

Cureus

Abdominal tuberculosis (TB) is a common form of extrapulmonary TB (EXPTB). It is being reported increasingly, especially in high-burden regions of the world. We present a case of a 37-year-old male who presented to the emergency department with clinical features suggestive of bowel obstruction. On clinical examination, the patient exhibited generalized tenderness in the abdomen. A subsequent CT scan revealed features consistent with small bowel obstruction. The patient underwent a diagnostic laparoscopy, which was converted to an exploratory laparotomy due to intraoperative findings of adhesions. Notably, there were extensive peritoneal deposits and adhesions between bowel loops. Peritoneal biopsies were obtained and subjected to the acid-fast bacillus (AFB) smear and culture, which demonstrated the growth of the Mycobacterium tuberculosis complex. As a result, the patient was initiated on antituberculous therapy.