SURGICAL MANAGEMENT OF ABDOMINAL TUBERCULOSIS

Objectives: To evaluate various surgical procedures for abdominal tuberculosis.Material and Methods: This study was conducted in general surgical department of Pakistan Institute of Medical Sciences Islamabad from January 1997 to December 1999. The study included 50 consecutive cases of abdominal tuberculosis diagnosed on tissue histopathology. All these patients underwent laparotomy for management of their abdominal tuberculosis and at the same time tissue was obtained for confirmation of diagnosis.Results: Laparotomy findings were, adhesions and bands in 25(50%), strictures in 21(42%), isolated enlarged mesenteric lymph nodes in 2(4%) cases and involvement of liver and appendix in one case each. Two or more of the above findings were present in most of the patients. The operative procedures performed were resection and end to end anastomosis in 16 strictures, strictureplasty in 6, Rt hemicolectomy in one and resection and ileostomy in 3 strictures which were associated with proximal perforations. Lysis of adhesions was possible in 19(38%) cases. Only biopsy was taken in 8(16%) and in 2(4%) appendectomy was performed.Conclusion: It was concluded that surgery is required for complications of abdominal tuberculosis and at the same time tissue is obtained for diagnosis.