A PROSPECTIVE CLINICAL STUDY OF ABDOMINAL TUBERCULOSIS AT GOVERNMENT GENERAL HOSPITAL, KAKINADA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 39
Abstract
BACKGROUND In spite of considerable advances in recent times, tuberculosis particularly of the abdomen still continues to be a major health problem in India. Several recent developments, which have influenced the incidence as well as the clinical course of tuberculosis in general warrant a fresh look at abdominal tuberculosis. 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 a great mimic and an important cause of morbidity. MATERIALS AND METHODS The study was done at Rangaraya Medical College and Government General Hospital, Kakinada, from August 2014 to August 2016. 50 cases have been studied. 39 cases underwent definitive surgeries. Follow up period ranges from 1 month to 22 months. RESULTS The age range of the patients was 15 to 70 years and most commonly involved age group was 20-40 years. Male-to-female ratio was 1.5:1. Most of the patients belonged to the low socioeconomic group. 12% of the patients had a positive history of contact. 60% of the patients presented with intestinal obstruction. The most commonly involved site was the ileocaecal region (44%). Most common surgical procedure done was limited (segmental) resection (46%). All cases were discharged on 6 months ATT. CONCLUSION Clinical diagnosis of intestinal tuberculosis remains challenging and can only be made after correlating clinical presentation with biochemical and radiological investigations. Haematological investigations were supportive only in 45% of the patients and were nonspecific for making definitive diagnosis. USG was found to be the best noninvasive imaging modality for the diagnosis followed by CT scan of the abdomen. Colonoscopy, laparoscopy and laparotomy with biopsy were accurate when tissue was available for histopathology. We conclude that a good history, clinical examination supported by blood investigations, radiological investigations and where applicable invasive investigations collectively can help experienced clinician to make a diagnosis of abdominal tuberculosis.
Authors and Affiliations
Veerabhadra Rao Sirigineedi, Ramarao Kamadi
Keywords
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- EP ID EP219168
- DOI 10.18410/jebmh/2017/463
- Views 98
- Downloads 0
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