Incidence of Abdominal Tuberculosis in 186 cases of Acute Abdomen presenting in our Surgical Emergency Department

Abstract

Objective: Among 186 cases of Acute Abdomen, determining the frequency of Abdominal Tuberculosis patients with their outcome. Design & Duration: A prospective case study from January, 2009 to June 2010. Setting: Surgical Unit-V District Headquarters (Teaching) Hospital, Faisalabad. Methodology: Detailed data of each patient including presentation, operative findings, procedure performed, post operative outcome and histopathology was entered on a specially designed Performa, compiled and analyzed. Results: During the period of study, 186 patients presented in the surgical emergency with complaints of acute abdomen out of which 54 (29.03%) were of abdominal tuberculosis. Mean age of presentation was 27.3 years. Operative findings showed predominance of ileocaecal hypertrophic tuberculosis (tuberculous mass) in 18 (33.33%) patients, followed by tuberculous adhesions, ileal strictures and plastic gut. The surgical procedures were performed according to their intra-abdominal findings out of which right hemicolectomy with ileocolic end to end anastomosis in 18 (33.33%) patients remained the commenest procedure performed followed by segmental ileal resection anastomosis, ileostomy and stricturoplasty. 20 (37.04%) patients reported to have post-operative complications in which wound infection in 7 (12.96%) remained the highest occurring post- operative complication followed by intra-abdominal collection, anastomotic leakage and septicemia. Mortality rate among the patients of abdominal tuberculosis in this study remained 5.56%. Conclusion: Complicated abdominal tuberculosis is the most common pathology of acute abdomen. By proper management of pre-complicated abdominal tuberculosis, this disastrous stage of disease resulting in so morbidity and mortality can be reduced.