Abdominal tuberculosis: epidemiologic profile and management experience of 233 cases

To document the epidemiologic profile and management outcome of patients with abdominal tuberculosis in a tertiary care setup.

This descriptive case series was conducted at the Department of Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, between January 2003 and December 2008. All adult patients of either gender who presented with abdominal tuberculosis and were managed at our hospital during the study period were included in the study on the basis of convenience sampling. Numerical data were expressed as mean +/- standard deviation, while categorical data were analysed using SPSS version 10. Chi square test was conducted to compare categorical variables.

Of the 233 adult patients with abdominal tuberculosis who were part of the study, 110 (47.21%) were males and 123 (52.78%) females. The mean age was 28.21 +/- 5.75 years. Majority of our patients (80.68%) belonged to poor families. History of concomitant pulmonary tuberculosis was found in 23 (9.87%) patients. Family history of tuberculosis was found in 13 (5.57%) patients. Of the patients 157 (67.38%) presented with acute abdomen; strictures were the most common operative finding (n = 161; 69%); the patients needing hospitalisation were 204 (87.55%), with the mean hospital stay being 19.55 +/- 4.51 days. The in-hospital mortality was 5 (2.14%).

Abdominal tuberculosis was found prevalent in the population and predominantly affected the younger lot belonging to the poor socioeconomic strata. Majority of the cases were of primary intestinal variety, and in a small proportion it was secondary to pulmonary tuberculosis. Majority of the patients presented with complications such as acute intestinal obstruction, intestinal perforation and peritonitis, necessitating emergency laparotomy.