Veerabhadra Rao Sirigineedi1, Ramarao Kamadi2
BACKGROUND
In spite of considerable advances in recent times,
tuberculosis particularly of the abdomen still continues to be a major health
problem in India. Several recent developments, which have influenced the incidence as well as the clinical course of
tuberculosis in general warrant a fresh look at abdominal tub erculosis. The disease is a diagnostic enigma and the
management is still controversial. Surgical treatments, both radical and conservative are being advocated. Approximately, one
fifth of patients require surgical intervention. Abdominal Tuberculosis (ATB ) is a great mimic and an important cause of
morbidity.
MATERIALS AND METHODS
The study was done at Rangaraya Medical College and Government General Hospital, Kakinada, from August 2014 to August
2016. 50 cases have been studied. 39 cases underwent definitive surgeries. Follow up period ranges from 1 month to 22
months.
RESULTS
The age range of the patients was 15 to 70 years and most commonly involved age group was 20
40 years. Male to female
ratio was 1.5:1. Most of the patients belonged to the lo w socioeconomic group. 12% of the patients had a positive history of
contact. 60% of the patients presented with intestinal obstruction. The most commonly involved site was the ileocaecal region
(44%). Most common surgical procedure done was limited (segme ntal) resection (46%). All cases were discharged on 6
months ATT.
CONCLUSION Clinical diagnosis of intestinal tuberculosis remains challenging and can only be made after correlating clinical presentation with biochemical and radiological investigations. Haematological investigations were supportive only in 45% of the patients and were nonspecific for making definitive diagnosis. USG was found to be the best noninvasive imaging modality for the diagnosis followed by CT scan of the abdomen. Colonoscopy, laparoscopy and laparotomy with biopsy were accurate when tissue was available for histopathology. We conclude that a good history, clinical examination supported by blood investigations, radiological investigations and where applicable invasive investigations collectively can help experienced clinician to make a diagnosis of abdominal tuberculosis.
