Presentation and Outcome of Abdominal Tuberculosis in a Tertiary Care Unit

Objective: To determine the presentation of abdominal tuberculosis and its outcome in terms of morbidity and mortality. Study design: Retrospective chart review Place and duration of study: This study was conducted at the Department of General Surgery, Pakistan Institute of Medical Sciences , Islamabad and included patients with abdominal tuberculosis managed between Jan 2007 to Dec 2009. Materials and Methods: All adult patients of either gender who presented with abdominal tuberculosis and were managed during the study period were included in the study. Records of the patients were retrieved and reviewed to measure parameters of age, gender , mode of presentation, evidence of co-existing tuberculosis , family history, socioeconomic status and drug history of anti tuberculous treatment . The treatment modalities were also reviewed and included the duration of hospital stay. The diagnosis of abdominal tuberculosis was confirmed by histopathology. Results: A total of 92 patients were included in the study. Out of these, 57 patients (62%) were female and 35 patients (38%) were male. The mean age was 37 ± 16.23 years. 42 patients (45.6%) presented with acute while 5 patients (5.4%) presented with subacute intestinal obstruction. 38 patients (41.3%) presented with signs of peritonitis. 7 patients (7.6%) with mass right iliac fossa. 4 patients (4.4%) were treated conservatively while rest of them 88 (95.6%) had surgery. Emergency laprotomy was performed in patients with peritonitis. Two staged procedures were performed in 57 patients (64.7%) During hospital course, 12 (13.6%) patients had post operative complications in which wound infection was most common. All patients were prescribed anti tuberculous therapy for 12 months duration. Mean hospital stay was 16 ± 14.67 days. Conclusion: Abdominal tuberculosis frequently presents as acute abdomen in our set up. It predominantly affects the young females of poor socioeconomic background. It poses significant morbidity as majority of the patients need surgical intervention and prolonged hospitalization in addition to chemotherapy with anti tuberculous drugs.