Clinico-Pathological Profile and Surgical Outcome of Patients of Gastrointestinal Tuberculosis Undergoing Laparotomy

Pathak, Priyank; Sahu, Shantanu Kumar; Agrawal, Sanjay

doi:10.21614/chirurgia.111.6.487

Cited by 10 publications

(11 citation statements)

References 7 publications

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“…nutritional status, with concurrent signs of pulmonary TB as well as a high rate of intra/preoperative positivity of tissue samples for tuberculosis/acid-fast bacilli (AFB). [12][13][14][15][16][17][18] As with those studies, intestinal obstruction due to varied mani-festations of abdominal Koch's was the commonest etiology for surgical intervention, followed closely by bowel perforation, intra-peritoneal abscess, etc. [9][10][11] Stoma formation was required in most cases, as was the wound complication rate, despite adequate care, whereas, death rate was low.…”

Section: Resultsmentioning

confidence: 99%

Koch's abdomen- management of surgical complications and outcomes at a remote hill area tertiary care center

et al. 2019

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Background: Abdominal tuberculosis needs surgical intervention in a subset of patients; both in emergency and elective settings, requiring surgeons to be familiar with its varied and non-specific modes of presentation and their diagnosis and management.Methods: Patients of abdominal tuberculosis, having undergone surgical management at our Institute, VCSGGMS&RI-UT, between April 2015 to March 2019, numbering eighty (n= 80), were included in this concurrent observational study.Results: Middle age-group patients (20-50 years; 56.3%) with a male majority (73.8%) predominated. Reinfection/ relapse of tuberculosis infection might occur despite BCG immunisation (46.3%) and course of ATT (16.3%); complications like bowel obstruction (28; 35%), perforation etc. need laparotomy to effect relief, with stomy formation required (51.3%) frequently; inadequate recovery warranting a secondary/re-look laparotomy (15; 18.8%). Prolene suture for abdominal wound closure is advantageous with a lesser rate of complications and incisional hernia. Septicemia, multi-organ dysfunction, wound infection should be aggressively managed to prevent adverse outcomes, including death (10; 12.5%).Conclusions: Adequate, intensive and timely surgical intervention/laparotomy, with nutritional support, stomy care and concurrent ATT can result in prompt relief and speedy recovery of patients with abdominal tuberculosis.

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Section: Resultsmentioning

confidence: 99%

Koch's abdomen- management of surgical complications and outcomes at a remote hill area tertiary care center

et al. 2019

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“…In this study, 61.2% subjects presented with obstruction and 29% with peritonitis. 13 On the study of Afridi et al, only 16% subjects treated with anastomosis and found 12.5% subjects with anastomosis leaks. 14 On study of Islam et all, out of 37 subjects with peritonitis and ten subjects with frozen abdomen, three subjects treated with anastomosis and all were found leaks.…”

Section: Discussionmentioning

confidence: 96%

“…Anastomosis leaks found in a subject who underwent bypass anastomosis for a severe adhesion, as resection is not possible to proceed. Pathak et al 13 reported one enterocutaneous fistula out of 49.9% resection and anastomosis. Charokar et al 16 found no anastomotic leakage in primary perforation repair.…”

Section: Discussionmentioning

confidence: 98%

Anastomosis in Intestinal Tuberculosis: A Systematic Review

Putranto

Muchtar

2018

NRJS

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Introduction. The heterogeneity of manifestations in intestinal tuberculosis requires different approach. One step or two steps surgical procedure referred to the method of choice to reduce morbidity and mortality. The review aimed to find out the indication to perform primary anastomosis in intestinal tuberculosis. Method. A systematic review was conducted in accordance with PRISMA guideline in June 2018. Literature searches were performed through online databases sites (PubMed, EBSCO, and Ovid) using keywords "intestinal tuberculosis" AND "surgery" AND "anastomosis". Intestinal pathology, surgical procedures, anastomosis leaks, enterocutaneous fistula, and mortality were the variables of outcome have been analyzed. Results. Twelve articles of cohort studies were critically appraised and analyzed. The selection of the surgical procedure depends on condition, extent disease, nutritional status, and surgeon's preferences. Resection and primary anastomosis are safe in an obstructive lesion with low incidence of enterocutaneous fistula and anastomosis leaks. The two steps procedure is advisable in intra-abdominal sepsis. Conclusion. In subjects without intra-abdominal sepsis, intestinal resection with primary anastomosis as a definitive procedure might be considered in obstructive lesions and in perforated lesions, with low risk to have anastomosis leaks and enterocutaneous fistulas. In contrast, in septic subjects, two steps procedure is advisable.

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“…Saat ini diagnostik berdasarkan gejala klinis, endoskopi, radiologi dan patologis akan menjadi kunci untuk mendiagnosis TB usus. 1,2,4,8 Umumnya tatalaksana TB usus dengan pemberian OAT dan pembedahan untuk memperbaiki komplikasi yang akan menghasilkan resolusi secara signifikan terhadap gejala gastrointerstinal. Adanya komplikasi berupa perforasi usus, perdarahan gastrointestinal, obstruksi total pada pasien akan memberikan prognosis yang buruk.…”

Section: Kesimpulanunclassified

Seorang Wanita Muda dengan Tuberkulosis Usus Menyerupai Apendiksitis Akut

Widianiti

Kusmiati

Ngurah

2019

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Background: Tuberculosis has become a global health problem, with increasing numbers of cases in line with the increasing number of immunocompromised patients. Intestinal of tuberculosis is believed to be a form of extrapulmonary tuberculosis which will occur most often in the future. Case: This case presents a young woman, 20 years old, suspected of acute appendicitis with suspected perforation, had right abdominal pain since 1 month and getting worse since 5 days PTA (prior to admission). The abdomen enlarges and feels hard on the right abdomen after being treated for 3 days. Fever,body weaknes,decreased of appetite, decreased of body weight approximately 7 kg since 2 months PTA. There are nausea, vomiting, diarea with runny mucus since 2 weeks PTA. The chest x-ray, abdominal ultrasound, endoscopy was normal result and plain abdominal radiograph showed that intestinal dilatation and step ladder features suspicious obstructive ileus. Discussion: After 2 months of therapy abdominal symptoms improved and weight began to gradually increase. Intestinal of tuberculosis is a challenge for clinicians to diagnose despite using modern medical techniques because the clinical and laboratory features are not specific especially when active pulmonary infection is absent and there are similarities with other abdominal diseases. The histological features will provide a diagnose. The delay in diagnosis will lead to more severe complications. Conclusion: At present a combination of clinical, radiological and pathological features continues to be the key to diagnosing intestinal tuberculosis. Medical management with antituberculosis drugs will produce a significant resolution of symptoms.

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Clinico-Pathological Profile and Surgical Outcome of Patients of Gastrointestinal Tuberculosis Undergoing Laparotomy

Cited by 10 publications

References 7 publications

Koch's abdomen- management of surgical complications and outcomes at a remote hill area tertiary care center

Koch's abdomen- management of surgical complications and outcomes at a remote hill area tertiary care center

Anastomosis in Intestinal Tuberculosis: A Systematic Review

Seorang Wanita Muda dengan Tuberkulosis Usus Menyerupai Apendiksitis Akut

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