A STUDY ON VARIOUS MODES OF PRESENTATION OF GASTROINTESTINAL TUBERCULOSIS AT EMERGENCY, ITS MANAGEMENT AND OUTCOMES
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2016, Vol 3, Issue 15
Abstract
Abdominal tuberculosis is the 6th most common form of extrapulmonary tuberculosis, among which ileocaecal tuberculosis is most common. Tuberculosis has been declared a global emergency by the World Health Organization (WHO) and is the most important communicable disease worldwide. Approximately one third of the world population is infected and about three millions die each year from this disease. It presents with a wide variety of symptoms and signs. Gastrointestinal tuberculosis presents to emergency department as subacute intestinal obstruction, acute intestinal obstruction and peritonitis. Although Antitubercular chemotherapy is the mainstay in treatment of abdominal tuberculosis, surgical intervention becomes necessary for two reasons- diagnostic and therapeutic. Diagnostic laparotomy becomes necessary for histopathological/microbiological diagnosis, more often in patients with peritoneal or lymph node TB. Therapeutic surgery is the treatment of choice in emergency for treating intestinal obstruction & peritonitis. Morbidity and mortality will be high in patients with late presentation and associated comorbidities. AIMS AND OBJECTIVES: (1) To study various modes of presentation and management of Gastrointestinal Tuberculosis at emergency surgical care, in our hospital, its management and outcomes. (2) To evaluate the morbidity and mortality in acute presentations of Gastrointestinal tuberculosis. MATERIALS AND METHODS An Observational study of 40 patients admitted in the acute surgical care unit of Our Hospital, Hyderabad, presenting with acute abdomen who have been confirmed to have Gastrointestinal tuberculosis at laparotomy and on histopathology from Aug 2013 to Aug 2015. The patient was managed by laparotomy and procedure according to the mode of presentation. All the patients were given ATT post operatively. RESULTS Gastrointestinal tuberculosis is more common in 2nd and 3rd decade of life. Acute presentations were found to be more common in male. Intestinal obstruction is one of the commonest presentation of gastrointestinal tuberculosis presenting as surgical emergency and contributes significantly to high morbidity and mortality. Morbidity and mortality is less in the study due to early intervention and effective chemotherapy. CONCLUSION A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis and timely definitive treatment, in order to decrease the morbidity and mortality associated with this disease.
Authors and Affiliations
Krishna Mohan N, Ramesh D, Gayathri Reddy K
Keywords
Related Articles
- EP ID EP233365
- DOI 10.18410/jebmh/2016/123
- Views 91
- Downloads 0
DIAGNOSIS OF A RUPTURED CEREBRAL ANEURYSM ON 128 SLICE CT CEREBRAL ANGIOGRAPHY
Conventional angiography is the gold standard for detecting cerebral aneurysm but multisclice CT cerebral angiography has gained significant role in diagnosing cerebral aneurysms because of its non invasive nature and in...
A STUDY ON MORPHOMETRY OF ARTICULAR CARTILAGE OF TIBIOFIBULAR MORTISE
Talocrural joint is a major weight bearing joint of the body. The objective of the study is to find the mean measurements of the articular cartilage of the tibiofibular mortise in south Indian population, differences bet...
POST STERILISATION ECTOPIC PREGNANCY IN A TERTIARY CARE CENTRE IN NORTH KERALA
BACKGROUND To study the proportion of ectopic pregnancies with a history of female sterilisation and to assess the risk factors associated with post sterilisation ectopic pregnancy. MATERIALS AND METHODS This is a descri...
SCREENING FOR PREECLAMPSIA AND FOETAL GROWTH RESTRICTION BY UTERINE ARTERY DOPPLER AT 11-14 WEEKS OF GESTATION
BACKGROUND Preeclampsia which is one of the five hypertensive disorders of pregnancy is common with an incidence of 6-8% and form one of the deadly triad, along with haemorrhage and infection, that contribute greatly to...
DIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS) VERSUS TRADITIONAL ASSESSMENT METHOD FOR NASOGASTRIC TUBE INSERTION SKILL
BACKGROUND The mantra of a good medical teaching-learning process is “Assessment Drives Learning.” At present many practical bedside skills of medical students (interns) are taken for granted and assessed in a cursory tr...