Presentations of Tuberculous Acute Abdomen; 100 Cases at Tertiary Care Centre

Abstract

Objective: To determine the various presentations of acute tuberculous abdomen at PUMHS Nawabshah. Study design: Cross sectional descriptive. Place & duration: Surgical unit 3, Peoples University of Medical and Health Sciences Nawabshah. From January 2010 to December 2015. Material and methods: The study was conducted on first hundred consecutive patients who presented with acute abdomen and underwent surgical exploration revealed histopathologically prove in abdominal tuberculosis. Data was analyzed for age, sex, history of tuberculosis, socio economic status, clinical findings, per-operative findings, operative procedures, post-operative morbidity and mortality. SPSS-18 (statistical package for social sciences) was used for data analysis. Results: A total of 100 patients were included in this study. 45 were male and 55 were female making a ratio of 1:1.2. Mean age was 30 years with SD 7.26 years. 92% patients were belonging to low socio economic group and 8% to middle group. 38 patients were already known cases of pulmonary tuberculosis while 45 patients have family history of tuberculosis. 51 cases had peritonitis due to intestinal perforation. 34 cases had intestinal obstruction due to multiple stricture in 16 patients, solitary stricture in 5patients and ileo-caecal tuberculous mass in 13 patients. 12 patients had acute appendicitis while 3 patients were found to have plastered abdomen. Re-do surgery was needed in 4 patients. 23 cases had severe post-operative wound infection and 7 patients had complete wound dehiscence. Mortality rate was 10%. Conclusion: In areas of high prevalence of tuberculosis, the disease can present as acute abdomen. The common presentations of acute tuberculous abdomen were peritonitis, intestinal obstruction and appendicitis. The condition had a high mortality rate that could be reduced by adopting operative conservative approach, making covering stoma formation.