Acute Presentation and Management of Abdominal Tuberculosis

Objective: To study the clinicopatholgical profile and outcomes of surgical management of abdominal tuberculosis (ATB) Study Design: Cross-sectional observational study. Place and Duration of Study: Department of Surgery, Services Hospital, Lahore, Pakistan, from May 2008 to April 2018. Methodology: All patients who underwent emergency laparotomy during the study period due to abdominal tuberculosis, and consented to participate in the study were included. Demographic variables and type of surgical procedure performed were recorded. Patients were followed-up for histopathology, recurrence, or any anti-tuberculous therapy related complications at 1, 4, 6, and 12 months. Data were analysed using SPSS version 21. Results: Out of the 80 patients, 36 were males and 44 were females. The median age was 23.5 years (range = 11-90 years). Mean weight of the patients was 48.7 +/- 12.2 kg. Commonest presenting symptom was abdominal pain 72 (90%). On exploration, ileocecal region was most commonly involved segment 68 (85%). Stoma formation was the most common surgical procedure performed in 59 (73.8%) patients. Complications and mortality rate were 48 (60%) and 7 (8.7%), respectively. A significant relationship of complications was found with prolonged hospital stay (p <0.001). Conclusion: Abdominal tuberculosis is a major public health concern. Vague symptoms lead to diagnostic delay so patients present late with intestinal obstruction. Ileocecal tuberculosis is the most common site of involvement.