Conservative surgical management of intestinal tuberculosis

Forty-seven proved cases of intestinal tuberculosis admitted to the surgical ward of MKCG Medical College, Berhampur from 1985 to 1987 were subjected to laparotomy. The common pathology found were tubercles over the peritoneum, multiple strictures of intestine, ileocaecal mass, perforation of the intestines, bands and adhesions and mesenteric node involvement. The patients with acute abdomen were operated in emergency and rest as an elective procedure. Conservative surgeries like stricturoplasty, local intestinal resection, perforation closure, by-pass procedures and local ileocaecal resection were done in most of the cases and only in 2 cases right hemicolectomy was done. Biopsy was taken from the viscera, peritoneum and mesenteric nodes. Postoperative mortality was 6.4%, mostly due to toxaemia and fluid and electrolyte imbalance. Postoperative complications in most of the cases were wound infection. All were given a short course of antituberculosis regimen containing INH, rifampicin and ethambutol. Patients were followed up to one year and definite improvement was noted.