Varied Clinical Presentations of Abdominal Tuberculosis Causing Bowl Obstruction
DOI:
https://doi.org/10.52206/jsmc.2024.14.4.943Abstract
Background: This study investigates the clinical presentations and surgical outcomes of abdominal Koch's disease, a common cause of intestinal obstruction, and the outcomes of surgical interventions.
Objective: To evaluate the clinical presentations, surgical outcomes, and postoperative progress in patients with abdominal tuberculosis causing intestinal obstruction.
Materials and Methods: A study of 50 patients diagnosed with abdominal TB at DHQ Teaching Hospital from 16 September 2021 to 16 September 2022 found that 80% were emergency cases, with a male-to-female ratio of 1:1.2, and a mean age of 24 years. The majority were Afghan nationals, with a majority coming from lower-middle socioeconomic backgrounds. Common symptoms included abdominal pain, distension, constipation, vomiting, weight loss, pallor, abdominal tenderness, and a mass in the abdomen. Laboratory findings included anemia, leukocytosis and raised ESR. Imaging findings showed distended small bowel loops and multiple air-fluid levels in 80% of cases, while 20% had evidence of coexisting pulmonary Koch's on chest X-rays.
Results: Abdominal Koch's is diagnosed 50% of the time, with 35% of confirmed cases having positive clinical findings. Common lesions included strictures, ileocecal masses, and intestinal perforations. Surgical procedures varied, and patients received full antitubercular therapy postoperatively. Complications occurred in 30% of cases, and hospital mortality was 4%.
Conclusions: Abdominal tuberculosis, a major cause of intestinal obstruction, but it is mostly asymptomatic and commonly affecting lower-middle socioeconomic groups. Surgical intervention and antitubercular therapy often led to improvement, but postoperative complications and mortality persist.
Keywords: Abdominal tuberculosis, Intestinal obstruction, Mycobacterium tuberculosis.
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