OBJECTIVES: To determine the mode of presentation in intestinal tuberculosis and effectiveness
of various surgical procedures adopted in our set up.
DESIGN: A descriptive study.
SETTING: Liaquat University Hospital, Hyderabad from June 1996 to May 1998 and Muhammad
Medical College Hospital Mirpurkhas, Sindh from April 2002 to March 2004.
METHODS: One hundred-twelve cases of intestinal tuberculosis were studied, which were operated
and diagnosis was confirmed on biopsy. Data collection included detailed history particularly
duration of symptoms, respiratory complains, dietary habits and bowel habits. At Liaquat
University Hospital, 1872 patients were admitted, 386 (20.61%) were operated for abdominal
complains (acute, sub-acute or chronic intestinal obstruction or perforation) and 80 (4.27%)
were diagnosed as having intestinal tuberculosis.
Meanwhile, 624 patients were admitted in Muhammad Medical College Hospital Mirpurkhas. Of
these, one hundred-seventy (27.24%) were operated for abdominal pathology and 32 (5.12%)
cases were proved as intestinal tuberculosis on histopathology.
RESULTS: Out of total 112 cases of intestinal tuberculosis, 64 (57.20%) were male and 48
(42.80%) females. Age ranged from 8 to 55 years with majority in 2nd and 3rd decades. Resection
and anastomosis of small gut, limited right hemicolectomy, right hemicolectomy, stricturoplasty,
ileostomy, adhenolysis and evacuation of pus were the procedures adopted for management.
Post-operative complications were seen in 30.65% of patients with wound infection on
top, however, mortality remained 3.57%.
CONCLUSION: The mortality of intestinal tuberculosis is high due to delay in diagnosis and under
dosage or irregular anti-tuberculous treatment. In complicated cases, surgery is indicated.
When multiple strictures or perforations are present, resection and end to end anastomosis is
required. In case of caecal mass (fungating type), right hemicolectomy can be performed and in
cases where extensive adhesions are present and there is fear of iatrogenic perforation, in attempts
to mobilize right colon, limited right hemicolectomy shall be performed.
Key words: Tuberculosis. Intestine. Management. Surgery.