Volume : 7, Issue : 8, August - 2018

SURGICAL MANAGEMENT OF ABDOMINAL TUBERCULOSIS- A NOVEL APPROACH

T. Chitra, N. Soundharrajan

Abstract :

<p class="MsoNormal" style="line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">Background of the study</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:<span style="mso-spacerun:yes">&nbsp; </span>In spite of considerable advances in recent times, tuberculosis, particularly of the abdomen<span style="mso-spacerun:yes">&nbsp; </span>is<span style="mso-spacerun:yes">&nbsp; </span>the<span style="mso-spacerun:yes">&nbsp; </span>major health problem in<span style="mso-spacerun:yes">&nbsp; </span>India.<span style="mso-spacerun:yes">&nbsp; </span>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 the most important cause of morbidity.<o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">Materials and methods:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp; </span>The study was done in Govt. Rajaji Hospital and Madurai Medical College from September 2013 to September 2014. 50 cases have been studied. 49 cases underwent definitive<span style="mso-spacerun:yes">&nbsp; </span>surgeries. Follow up period ranges from 1 month to 22 months.<o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">Results:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp; </span>The age range of the patients was 16 to 60 years and most commonly involved age group was 20-40 years with Male to female ratio of 1.5: 1. 12% of the patients had a positive history of contact. 60% of the patients presented with intestinal obstruction.<span style="mso-spacerun:yes">&nbsp; </span>The<span style="mso-spacerun:yes">&nbsp; </span>most<span style="mso-spacerun:yes">&nbsp; </span>commonly<span style="mso-spacerun:yes">&nbsp; </span>involved<span style="mso-spacerun:yes">&nbsp; </span>site<span style="mso-spacerun:yes">&nbsp; </span>was<span style="mso-spacerun:yes">&nbsp; </span>the<span style="mso-spacerun:yes">&nbsp; </span>ileocaecal<span style="mso-spacerun:yes">&nbsp; </span>region (44%). Most common surgical procedure done was Limited (segmental) resection (46%).All cases were discharged on 6 months ATT.<o:p></o:p></span></p> <p class="MsoNormal" style="line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">In<span style="mso-spacerun:yes">&nbsp; </span>the<span style="mso-spacerun:yes">&nbsp; </span>present<span style="mso-spacerun:yes">&nbsp; </span>series<span style="mso-spacerun:yes">&nbsp; </span>the<span style="mso-spacerun:yes">&nbsp; </span>approach<span style="mso-spacerun:yes">&nbsp; </span>to<span style="mso-spacerun:yes">&nbsp; </span>surgery<span style="mso-spacerun:yes">&nbsp; </span>was<span style="mso-spacerun:yes">&nbsp; </span>conservative.<span style="mso-spacerun:yes">&nbsp; </span>Limited resection waspreferred over Right hemicolectomy. Most of the cases had uneventful post operativeperiod and showed good response to ATT during the follow up.<o:p></o:p></span></p>