Observational study to evaluate the clinical presentation, management, complications and outcomes in patients with abdominal tuberculosis
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 5
Abstract
Abdominal tuberculosis (AT) is one of the common extra-pulmonary tubercular infections. Its clinical presentation is protean and it has diagnostic dilemma, as most of the investigations are non-specific and less sensitive. Therefore this study was undertaken to define the most suggestive clinical features of AT and to find out the efficacy of most commonly available investigations for effective management of AT. Hundred cases of AT of either sex were studied in the department of surgery, TNMC and Nair Charitable Hospital, Mumbai. All the patients were clinically evaluated with meticulous history and physical examination and were investigated by available tests such as blood counts including HB, ESR, AFB, HIV, ADA, chest X-ray, abdominal X-ray, abdominal ultrasonography (USG), barium X-rays, CT scan of abdomen and colonoscopy in selected patients. Depending on the symptoms that was observed in the study AT was managed by conservative and operative therapy for a specific duration of time. Our study revealed the most common symptoms were abdominal pain 79 (79%), weight loss 70 (70%) and abdominal distention 56 (56%) observed in AT patients. Moreover we observed more common signs of AT were abdominal distention 36 (36%), pallor 27 (27%), abdominal tenderness 26 (26%) and organomegaly 20 (20%) in AT patients. Our results also suggested the more common site of involvement in AT patients were omentum and peritoneum 57 (57%), small bowel 51 (51%), large bowel 47 (47%), caecum 41 (41%), liver, spleen, pancreas 18 (18%) and mesentric lymph nodes 17 (17%). Diagnostic studies also suggested that about 50% patients were anemic, 8% were HIV positive and 3% were AFB positive. During our study, with the help of diagnostic parameters and the severity of disease about 54 patients were managed by conservative therapy while 46 patients need surgery. Out of 100 patients 61 patients were effectively managed and recovered whereas 30 patients got developed other complications. However 9 patients were reported dead during the study period.
Authors and Affiliations
Vivek G Supaha, Vinod N Rathod, Sonali Bhagwat
Keywords
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