Abdominal tuberculosis: a clinicopathologic study in Kashmir valley

Abstract

Background: Tuberculosis is a major health hazard in India. Because of its diverse manifestations, difficult diagnosis, widespread complications, prolonged morbidity and increased mortality the study of this disease becomes even more important. The objectives of the study were to study age and sex distribution of abdominal tuberculosis, to study association of abdominal tuberculosis with pulmonary tuberculosis, to study various clinical presentations of abdominal tuberculosis, to study various modalities for diagnosis of abdominal tuberculosis and to study the surgical management in relevant patients of abdominal tuberculosis.Methods: This study was carried out in 50 patients of abdominal tuberculosis of different age group and sex admitted in Department of Surgery, SMHS Hospital, Govt. Medical College, Srinagar during the period from 2002 to 2004. The patients of abdominal tuberculosis fell into two broad categories - those presenting with acute/sub-acute intestinal obstruction and those without obstruction. All patients were worked up with the elicitation of proper history, clinical examination, laboratory investigation, etc. The diagnosis was confirmed by IgM ELISA for tuberculosis, peritoneocentesis, FNAC, laparotomy and biopsy of the specimen obtained at the time of surgery.Results: Maximum incidence of abdominal tuberculosis was noted in third and fourth decades followed by second decade of life. Males constituted 60% and females constituted 40% of total patients. 23 patients presented with acute and 27 patients with chronic onset of signs and symptoms respectively. Abdominal pain, anorexia, weight loss, weakness, vomiting and constipation were the main presenting symptoms. No haemoglobin and raised ESR were the commonest finding on routine laboratory investigations in majority of the patients. IgM ELISA for tuberculosis was positive in 41 patients (95.34%). Surgical intervention was required in 50% of the patients.Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and timely management of this curable disease.

Surgical interventions in abdominal tuberculosis: a clinico-pathological study

“…However, some studies have reported pallor as the most common sign. 5,13,15 Bowel adhesion was the most common intraoperative finding seen in 84% cases in our series, other studies have also shown bowel adhesion as the most common intra-operative finding. 15,17 Adhesiolysis was the most commonly performed single surgical procedure in 28% cases.…”

“…15 Awasthi S and Chalya PL observed that 22.6% and 29% respectively were associated with pulmonary tuberculosis. 10,12 Abdominal pain was the most common symptoms seen in 86% cases.…”

“…However, Rao V observed segmental resection as the most common performed surgical. 9,10,15,17 Wound infection was the most common complication seen in 34% cases. Charokar K, Chalya PL have also shown wound infection as most common post-operative complication seen in 29% and 37% respectively.…”