Experience with surgical management of intestinal tuberculosis at a rural teaching hospital

2016-02-01T06-03-16Z
Source: International Journal of Research in Medical Sciences
Mohammed Shamim Ali, Prince Pankaj, Deepak Pankaj, Sweta Muni.
Background: Tuberculosis is a major global health problem and still considered as a social disease in India reflecting the standards of living in a community. It possesses a diagnostic and therapeutic challenge to practicing surgeon in resource limited contries. The aim of the present study was to study different surgical management of Intestinal tuberculosis. Methods: 100 cases of intestinal tuberculosis were studied over a period of three years in the department of General Surgery at Katihar Medical College with emphasis on surgical management of these cases. Results: 64% of the cases were in the age group of 21-40 years. The sex incidence revealed a female to male ratio of 1.17:1 showing a female preponderance. Low haemoglobin value and high erythrocyte sedimentation rate with lymphocytosis were present in majority of the cases. Radiological finding in plain X ray abdomen was of definite diagnostic aid in cases of intestinal obstruction and perforation. On laparotomy, diagnosis was supported by presence of tubercles, macroscopic caseation, enlarged and calcified lymph glands, bands, adhesion and strictures. The commonest site involved was small bowel followed by the ileocaecal region. The commonest type of lesion was stricture, which mostly involved the small bowel followed by hyperplastic lesions which were more common in caecum and ascending colon. Acute complications of the disease were perforation and obstruction, which forced the patients to undergo emergency surgical treatment. Wound infection (30%) was the most common complication. Conclusions: Multidisciplinary approach with high index of suspicion for the disease is required in these cases. Mostly a disease of low socio - economic people, health education and awareness among people is the need as this disease is very prevalent in this region.


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