IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 3 Ver.8 March. (2018), PP 78-84 www.iosrjournals.org DOI: 10.9790/0853-1703087884 www.iosrjournals.org 78 | Page Gastrointestinal Tuberculosis: Clinico-Pathological Profile and Surgical Outcome of Patients Undergoing Laparotomy Shergill J S, Sharma S, Kaur R Corresponding Author: Ravinder Kaur Abstract: Tuberculosis is one of the earliest diseases affecting the mankind. Abdominal tuberculosis constitutes a common public health issue in developing countries like ours. Gastrointestinal tuberculosis often involves the ileo-caecal region. Surgery in case of abdominal tuberculosis is required to overcome the deleterious effects of the disease like tissue disorganization, obstruction and perforation.Aims And Objectives: 1. To study the various clinical profiles of gastrointestinal tuberculosis in patients undergoing laparotomy;2. To study the surgical pathology of gastrointestinal tuberculosis; 3. To study the various surgical treatment modalities based upon the intraoperative findings and its outcome. Results: This is a prospective study over 12 months at Government Medical College & Hospital Amritsar, Punjab. This study was done to study the clinic-pathological profile of gastrointestinal tuberculosis undergoing laparotomy. Incidence of gastro intestinal tuberculosis was seen highest in age group 15 to 25 years with male predominance. Most common presentation being intestinal obstruction with ileo-caecal as the most common area involved and right hemicolectomy as the commonest procedure done. Common surgical pathologies were ileo-caecal mass and ileal perforation and this also has relation to pulmonary tuberculosis.Conclusion: Inspite of specific antituberculous drugs and vast measures against the disease, including chemoprophylaxis and pasteurization, abdominal tuberculosis remains a fairly common disease even today. Gastrointestinal tuberculosis has an indolent course and the common mode of presentation is usually sub acute or chronic intestinal obstruction. Prompt surgical exploration, vigilant postoperative care and administration of ATT helped to treat the patients successfully with their complete cure and rehabilitation. Keywords: gastrointestinal tuberculosis, laparotomy, obstruction, perforation --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 05-03-2018 Date of acceptance: 19-03-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Tuberculosis is one of the earliest diseases affecting the mankind. Tuberculosis (TB) was a prevalent infection even in Ancient Greek and Egypt. It was known to Hippocrates who gave it the name of phthisis, which means wasting disease (1). In India, tuberculosis is still considered as a social disease, reflecting the standards of living in a community. Tuberculosis can quiet rightly be termed India's "National Disease". Abdominal tuberculosis constitutes a common public health issue in developing countries like ours. It is relatively less common in the western world. It can occur as a primary disease or develop secondary to pulmonary tuberculosis. It carries significant morbidity and mortality (2,3). The tubercle bacilli may reach the gastrointestinal tract via direct contact through the ingested food, swallowing infected sputum, haematogenous route, or may spread from infected adjacent lymph nodes and viscera such as fallopian tubes (4). Abdominal TB is predominantly a disease in young adults. Two thirds of the patients are of 21-40 years old and the sex incidence is equal (5). Gastrointestinal tuberculosis often involves the ileo-caecal region. The ileal and ileo-caecal regions are the most common sites affected. Associated colonic involvement is frequent and isolated colonic involvement is not uncommon. Abdominal tuberculosis may present clinically as an acute abdomen, either due to bowel obstruction, perforation or mass in right lower abdomen mimicing acute appendicitis or appendicular mass. Most of the patients present with chronic abdominal pain recurrent sub-acute obstruction and low-grade fever with or without weight loss (4). Surgical management of intestinal tuberculosis has changed considerably from bypass operation and hemi colectomy to conservative resections and stricturoplasty. Surgery in case of abdominal tuberculosis is required to overcome the deleterious effects of the disease like tissue disorganization, obstruction and perforation. The study is intended to know the various modes of presentation; different modalities of treatment and prognosis in our hospital.