Acute perforation of small intestine due to tuberculosis

Twenty-two patients with acute perforations of the small intestine due to tuberculosis were operated upon at Irwin Hospital, New Delhi between 1971 and 1976. Most of them (85.36%) presented with features of peritonitis. Radiologically, evidence of pneumoperitoneum was found in six patients. Fourteen patients had a solitary perforation while multiple perforations were found in eight cases. Sixteen patients had an associated stricture immediately distal to the perforation. Management of these patients included resection anastomosis (12), closure of perforation with bypass (seven), and simple repair of perforation in three cases. The overall mortality was 45.45%. Mortality was significantly higher (P less than 0.05) in patients with multiple perforations and in those who had multiple strictures. The high mortality and difficulty of correct pre-operative diagnosis have been stressed.