ABDOMINAL TUBERCULOSIS AN EXPERIENCE AT AYUB TEACHING HOSPITAL ABBOTTABAD
Abstract
Background: Abdominal tuberculosis is one of the common diseases in our country. This study wasperformed at Surgical A Unit Ayub Teaching Hospital Abbottabad from August 2006 to December2007 to asses the clinical presentation of abdominal tuberculosis and its management. Methods: Allpatients presenting to outpatient department with clinical feature suggestive of abdominaltuberculosis were included in the study. They were investigated. On the basis of clinical presentation,patients were divided in two groups. Patients with acute abdomen (peritonitis, intestinal obstruction)were prepared for laparotomy and operated upon. Required surgical procedure performed and tissuediagnosis was obtained. Patients with sub-acute obstruction, chronic pain abdomen and massabdomen with out peritonism were managed conservatively. These patients were started on anti TBdrugs on the basis of clinical and laboratory assessment. Empiric therapeutic trial was conducted forat least for 3 months with standard four drugs regimen. They were sent home on 9 month course ofAnti TB drugs and were advised to come for follow up twice a month. On reassessment good clinicalresponse was considered abdominal tuberculosis and anti TB continued with monthly follow up. Incase of no response patients were operated. Required surgical intervention performed and tissue wastaken to establish diagnosis. Detailed history, family history, examination findings, results ofinvestigations, operative findings of the histologically proven cases of abdominal tuberculosis wererecorded on a separate proforma and analyzed. Results: Amongst 76 patients majority were females52 (68.4%). Most of the patients were young with mean age of 34 years. Abdominal pain was themost common presentation 73 (96%) followed by fever and anorexia. Tender lower abdomen asfound in 53 (70%) patients and mass abdomen was found in 35 (46%). Family history of TB waspresent in 20 (26%). Fifty three (70%) patients underwent laparotomy. Bands and adhesion was themost frequent finding on laparotomy. Conclusion: Abdominal TB is more common in female andabdominal pain fever and nausea are the most common presentations.Keywords: Abdominal tuberculosis, abdominal mass, exploratory laparotomyReferences
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