Farhan Sadiq, Nadia Khurshid, Farah Nawaz.
Abdominal Tuberculosis - a continuing challenge to the surgeon.
Pak J Med Health Sci Jan ;6(4):898-900.
Objective: To determine various modes of presentation of abdominal tuberculosis on surgical floor and the outcome of different management strategies. Design: Prospective study Duration and place: The study was carried out from April 2005 to March 2007 at Mayo Hospital Lahore. Patients and methods: The study included 100 patients. Investigations carried out included complete blood counts, ESR, Mantoux Test, chest x ray, abdominal x-ray erect and supine view, barium meal and /or follow through in selective cases. Patients who had signs of acute abdomen or frank peritonitis were operated upon after adequate resuscitation. Patients with acute intestinal obstruction were given conservative trial for at least 48 hours. But conservative treatment was abandoned in favour of surgery if patient deteriorated clinically. All patients received standard anti tuberculous therapy for 12 months afterwards. Specimens were sent for histopathology for definitive diagnosis. Results: There were total 100 patients in the study. 43 were males and 57 were females. Age range was between 25 to 54 years with the median age of 34 years. Abdominal pain was the commonest presentation (82%). Total 83% patients were operated on. Commonest surgical procedure performed was loop ileostomy (64%). Post operative complications were seen in 17% of patients and the commonest complication was wound infection (47%). Conclusion: Most of the patients who present with abdominal tuberculosis are females and relatively younger. Majority of patients require surgical intervention which results in significant morbidity and at times mortality.
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