FREQUENCY OF INTESTINAL TUBERCULOSIS IN CASES OF INTESTINAL OBSTRUCTION

OBJECTIVE: To determine the frequency of intestinal tuberculosis in cases of intestinal obstruction. DESIGN: A descriptive, case review. SETTING: Jinnah Postgraduate Medical Centre, Karachi - Sindh, from September 1988 to September 1994. METHODS: Total five hundreds and ninety-two patients of intestinal obstruction were operated during study period. Out of these, ninety- three were found to have intestinal tuberculosis on histopathology. All these patients were admitted through Accident & Emergency or out-patient departments. RESULTS: Among ninety- three cases found to have intestinal tuberculosis; they included fiftyone females and forty-two male patients. Age varied from 12 to 68 years. Majority of patients was in second and third decades. Patients presented with asthenia, nausea, vomiting, fever, night sweats and weight loss. Forty-three patients, out of ninety- three had peritonitis. Exploratory laparotomy was performed in all cases. The site of gut involved was jejunum, terminal ileum and ileocaecal junction. However, ileum was found most frequently affected site in 51.61% cases. Operative findings inlcuded perforation of gut and mass in ileocaecal region in 30.27% cases each. Right hemicolectomy was performed in 45 (48.60%) cases followed by resection anastomosis in 24(25.72%), ileostomy in 15 and repair of perforation in 9 cases. Antituberculous therapy was given to all these patients. Mortality was 10% in these cases. CONCLUSION: Patients with intestinal obstruction, presenting with fever, loss of weight, nausea, and night sweats should be considered as intestinal tuberculosis until and unless proved otherwise. Laparotomy and histopathology are important for diagnosis and treatment of these cases.