SURGICAL MANAGEMENT OE INTESTINAL TUBERCULOSIS

Objective: To study the outcome of various surgical procedures performed for intestinal tuberculosis.Materia! ami Methods: This Study was carried out from July 2004 to June 2005 at Lady Reading Hospital, Peshawar on 30 operated patients of intestinal tuberculosis provisionally diagnosed on history, physical examination and x-ray findings, Emergency patients had a short work up including routine hamatological. biochemical and chest radiography while those admitted electively, had an ESR and upper gastrointestinal barium studies in addition to routine investigations. Final diagnosis was made after histopathologv. Different operative procedures were performed according to the available facilities and preoperative condition of the patient.Results: Study included 10 males and 20 females, ranging in age from 15-60 years with mean of 23.5 years. Twenty Seven patients (90%) were operated in emergency and 3 patients (10%) as elective cases. In 19 cases (63%): ileum was involved while combined ileum and jejunum in 6 cases (20%). Twenty patients (66%) had strictures in small gut. The most commonly performed procedures were resection and end to end anastamosis in the form of segmental resection (11 cases), striciuroplasty in 7 cases and loop ileostomy (5 cases). Wound infection was the main post-operative complication (7 cases). The average hospital stay was 10 days. Mortality was 10% (3 cases).Conclusion: Resection of the diseased segment is the standard procedure to relieve obstruction but in the presence of multiple strictures and limited bowel length, striciuroplasty is a better alternative.