International Surgery Journal | January-March 2016 | Vol 3 | Issue 1 Page 23 International Surgery Journal Charokar K et al. Int Surg J. 2016 Feb;3(1):23-31 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Research Article Surgical management of abdominal tuberculosis: a retrospective study from Central India Kailash Charokar*, Nitin Garg, Ajay Kumar Jain INTRODUCTION Tuberculosis, especially in developing countries is a major health problem, and causes significant morbidity and mortality. These countries have problems of poverty, overcrowding, and poor sanitation. The population is ignorant and malnutrition is prevalent. 1 World Health Organization (WHO) declared it a global emergency and is the most important communicable disease worldwide. 2,3 In India, tuberculosis is still considered as a social disease, reflecting the standards of living in a community. According to WHO report in 2013, there were an estimated 8.6 million annual incidence of TB globally, and India has the world’s largest tuberculosis cases which are around 26% of the world TB cases, followed by China and South Africa. Lungs are the most common site of infection. However tuberculosis can affect any part of the body. 4 Approximately one-eighth of total TB cases are extra-pulmonary. 3,5 Of these abdominal tuberculosis accounts for 11-16%. 4,6 It is estimated that in ABSTRACT Background: Abdominal tuberculosis is a diagnostic and therapeutic challenge in resource limited countries. The vague clinical presentation is a barrier to early diagnosis. The study aims to highlight the role of surgery in the diagnosis and treatment of abdominal tuberculosis. Methods: This is a descriptive study of abdominal tuberculosis cases, which were operated in the Department of Surgery, Peoples College of Medical Sciences & Research Centre, Bhopal from August 2010 to July 2015. Cases were analyzed in terms of demography, clinical features, investigations, operative treatment, and outcome. Results: 72 cases of abdominal tuberculosis were operated during the study period. The median age was 30 years with male to female ratio of 3:2. Primary abdominal tuberculosis was 79.2%. Intestinal tuberculosis was the commonest with terminal ileum and ileo-caecal region being predominantly involved. 58% of the patients required emergency surgery. Surgical procedures performed were: resection of the diseased segment including right hemi- colectomy 32 (44.44%), release of band/adhesions 23 (31.9%), perforation repair 11 (15.3%), stricturoplasty 4(5.5%), etc. In the presence of gross peritonitis, temporary ileostomy was performed. Complication and mortality rates were 33.3% and 2.6% respectively. No patient had post-operative intestinal-leak. The median duration of hospital stay was 14 days. Conclusions: Early diagnosis is the key factor in avoiding systemic and local complications of intestinal tuberculosis. In emergency cases, prompt surgical exploration and vigilant care is met with good recovery. Resection-anastomosis in the form of right hemi-colectomy or segmental resection has largely been adopted instead of simple bypass of obstructive lesions with good results. Keywords: Abdominal tuberculosis, Intestinal stricture, Bowel perforation, Resection anastomosis, Ileostomy Department of Surgery, People’s College of Medical Sciences & Research Centre, Bhopal, M.P, India Received: 23 October 2015 Accepted: 03 November 2015 *Correspondence: Dr. Kailash Charokar, E-mail: kcharokar@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20151217