Prevalence of Intestinal Tuberculosis in cases of acute abdomen-A study of 100 cases

Author(s): Md. Nashir Uddin, Tariq Akhtar Khan, Probin Kumar Mahato, Tarik Alam Ony, Mehfujul Hasan, Mohammad Haroon Or-Rashid, Mahmud Zaman Chowdhury, Fahim Hossain, Anjuman Sultana

Background: Intestinal tuberculosis (TB) is a form of extrapulmonary TB presenting as acute abdomen, caused by Mycobacterium tuberculosis infecting the gastrointestinal tract. It often leads to complications like perforation or obstruction, requiring surgical intervention. Diagnosis is challenging due to nonspecific symptoms, causing delays and increased morbidity. Awareness of intestinal TB in acute abdomen cases is crucial for timely diagnosis and management, improving outcomes.

Objectives: To determine the prevalence of Intestinal Tuberculosis in cases of acute abdomen with its various clinical presentation and treatment modalities.

Materials and methods: This cross-sectional observational study was conducted in the surgery in-patient department of Dhaka Medical College Hospital from January to June 2014. A total of 100 patients aged 11 to 80 years, of both sexes, were included. Patients with a history of trauma or children were excluded. Data on presentation, operative findings, procedures, outcomes, and histopathology were recorded and analyzed.

Results: Amongst the 100 patients with acute abdomen due to intestinal cause, 16 patients (16%) had intestinal tuberculosis on the basis of operative findings and histopathological reports. Age of the patients ranged between 16 to 80 years. Majority (70%) of the patients were seen between 20 to 40 years. Male female ratio of intestinal tuberculosis is 1:0.45. Six patients (37.5%) had evidence of pulmonary tuberculosis as well on chest X- ray and history. The commonest operative findings were ileal perforation in 50% patients, stricture constitute 25%. The common operation performed was loop ileostomy in about 56.25% patients. Patients presented with acute abdomen due to intestinal cause, post operative complications developed 37.5% in tubercular patients in contrast to non-TB patients and which is 25%. The overall mortality rate of acute abdomen was in my study is 6% but in cases of tubercular patients it was 0%.

Conclusion: Intestinal Tuberculosis is a common problem presenting to general surgical unit in the developing countries, often in an acute form. A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis, in order to minimize complications.