Does diverting ileostomy improve the outcome in children with tuberculous small bowel obstruction requiring surgical...

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Infectious Diseases

Background:

• Abdominal tuberculosis is a common pediatric condition, frequently presenting as bowel obstruction.
• Management options for intestinal obstruction include conservative measures or surgical intervention.
• Surgical approaches vary, with ileostomy being a potential consideration.

Purpose of the Study:

• To evaluate the outcomes of surgical intervention for small bowel obstruction caused by abdominal tuberculosis in children.
• To compare the effectiveness of operative treatment with and without ileostomy.

Main Methods:

• A retrospective study of 32 children operated for tuberculous small bowel obstruction over 10 years.
• Patients were divided into two groups: Group A (with ileostomy) and Group B (without ileostomy).
• Statistical analysis of relevant data and defined outcome measures was performed.

Main Results:

• Children with ileostomy (Group A) experienced a significantly shorter mean duration of postoperative ileus (2.55 days).
• Enteral feeding was restored earlier in the ileostomy group (mean 3.55 days).
• The primary hospital stay was significantly shorter for patients with ileostomy (mean 9.0 days).

Conclusions:

• Diverting ileostomy in pediatric abdominal tuberculosis with bowel obstruction reduces morbidity.
• Ileostomy facilitates earlier return of enteral motility and feeding.
• Ileostomy allows for earlier initiation of anti-tuberculosis therapy (ATT) and decreases primary hospital stay.