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Abdominal Tuberculosis (Study of 50 cases)

Ketan Vagholkar, Meghal Sanghavi, Suvarna Vagholkar.

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The incidence of abdominal tuberculosis is increasing. Preoperative diagnosis continues to be the biggest challenge. Diagnosis is established only after histopathological examination. The modes of presentation and therapeutic options need to be assessed.
To study the patterns of presentations, the extent of organ involvement and therapeutic options.
Materials and methods:
50 histopathologically proven cases of abdominal tuberculosis were studied. Epidemiologic data, clinical patterns of presentation, diagnostic and various surgical options including final outcomes were studied.
The mortality in the study was 8 %. The disease was commonly seen in the age group 21 to 40 years and commonly seen in females. HIV positivity, anaemia and hypoproteinaemia were associated with poor outcomes. Four types of presentations were observed. Diagnostic laparoscopy enabled early histopathological diagnosis of biopsy specimens. Chemotherapy is the mainstay of treatment Surgery is a significant adjunct both in diagnosis and management of complications. Patients presenting with perforative peritonitis had a poor prognosis
Conclusion: Critical evaluation of chronic abdominal pain is essential. Supportive evidence such as the history of TB or contact with a patient suffering from TB is highly suggestive of abdominal tuberculosis. Radiological tests are highly suggestive but not diagnostic. Diagnostic laparoscopy enables tissue diagnosis. Chemotherapy accompanied by surgical intervention for complications is the mainstay of treatment.

Key words: Abdominal, Intestinal, tuberculosis, diagnosis treatment

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