SURGICAL MANAGEMENT OF ABDOMINAL TUBERCULOSIS: A TERTIARY CARE HOSPITAL EXPERIENCE IN QUETTA

Abstract

Abdominal tuberculosis remains a significant health problem in developing countries like Pakistan, presenting with varied and non-specific clinical features. Timely diagnosis often requires surgical exploration due to overlapping symptoms with other abdominal pathologies. Understanding the frequency and surgical management patterns of this disease is crucial for improving patient outcomes in tertiary care settings.

Objective: To determine the frequency and surgical management patterns of abdominal tuberculosis in a tertiary care hospital setting.

Methods: This is Cross sectional study was conducted at the surgical department at Bolan Medical College Quetta Baluchistan 10th August 2022 - 10th August 2023.   

A total of 131 patients presenting with various abdominal complaints. All patients underwent detailed clinical evaluation, radiological imaging, and relevant laboratory investigations. Based on these assessments, 85 patients were selected for exploratory laparotomy due to strong clinical indications. During surgery, intraoperative specimens — including mesenteric lymph nodes, intestinal biopsies, and ascitic fluid — were collected and sent for histopathological and microbiological analysis. The remaining patients were managed conservatively with medical treatment and monitored for clinical improvement.

Results: A total of 131 patients presenting with acute abdomen were included in this study. Among them, 54 (41%) were male and 77 (59%) were female. The mean age of patients was 42 years with a standard deviation (SD) of ±10.43 years. Age distribution showed that 75 patients (57%) were between 18–40 years, and 56 patients (43%) were between 41–60 years. Out of all 85 underwent laparotomy based on clinical, radiological, and laboratory assessments. Various surgical procedures were performed in these cases. Of these, 8% were diagnosed with abdominal tuberculosis, confirmed through laboratory investigations such as histopathological examination and other relevant diagnostic tests.

Conclusion: Abdominal tuberculosis was identified in 8% of patients, predominantly affecting females aged 41–60 years. Surgical intervention was essential for diagnosis and management, with adhesiolysis and bowel resection being common procedures. Despite some postoperative complications, outcomes were favorable with timely surgical evaluation.