SURGICAL MANAGEMENT OF TUBERCULOUS SMALL BOWEL OBSTRUCTION

Authors

  • Mohammad Akbar
  • Fakhar -ul- Islam
  • Irfan Zaffar Haider
  • Danish Naveed
  • Ismail Akbar
  • Irfanuddin Khattak
  • Kehkashan Akbar
  • Arshad Zafar

Abstract

Background: Acute intestinal obstruction due to tuberculosis is a common surgical problem inour community. Emergency surgery is usually required and surgical procedure depends upon thelocation and extent of the disease. The aim of this study was to determine the commonly involvedregion of intestine and different surgical procedures tailored. Methods: Thirty patients operatedupon for acute intestinal obstruction in emergency with operative and histopathological findingssuggestive of tuberculosis were included in the study. Demographic profile, operative findings,details of surgical procedure, complications and post-op hospital stay were recorded. The patientswere followed for 6 months. Results: Intestinal tuberculosis is more common in young female,with male to female ratio of 1:1.5. Stricture of the small bowel was found in 50% of the cases. Thenext common finding was ileocaecal tuberculosis found in 40% of patients. Strictruplasty wasperformed in 11 (36.33%). The right hemicolectomy, limited ileocaecal resection and segmentalbowel resection with end to end anastomosis were performed in four patients each. Otherprocedures were release of adhesions and bands in 4 patients, ileotransverse bypass in 1 patientand loop ileiostomy in 2 patients. Major complication in 10 patient and mortality rate was 10%.Conclusion: Because of non-specific clinical features, ignorance and malpractice intestinaltuberculosis presents late. Ileocecal tuberculosis is becoming less common as compared to smallbowel strictures. Less radical surgery gives better results. Post operative complications andmortality are related to the perforation of the intestine at the time of surgery.Keywords: intestinal Tuberculosis, Right hemicolectomy, stricturoplasty

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2010-06-01

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