ISSN:
1437-9813
Keywords:
Abdominal tuberculosis
;
Complications
;
Surgical management
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract During the period 1980–1989, 95 patients, mean age 5 years, with abdominal tuberculosis (ATB) were seen at the Red Cross Children's Hospital. Eighty per cent were malnourished. Apart from fever, loss of weight, and failure to thrive, symptoms of abdominal pain, vomiting, and diarrhoea predominated. Abdominal distension (86%) and a palpable mass (57%) were the most common physical findings. Sixty-three per cent had radiological evidence of chest disease. Abdominal ultrasound was useful in identifying ascites and distribution of lymph node masses. Fifty of the 95 patients were managed on the surgical unit and the predominant involvement was: peritoneal 21, nodal 15, enteric 11, and undetermined 3. Thirteen of this group developed one or more complications — perforation (4), obstruction (7), abscess or fistulae (5), and haemorrhage (1). Surgery involved diagnostic laparotomy, extra-abdominal biopsy, and management of the complications. Emergency surgery was conservative. Definitive surgery for stricture-plasty, resection, and stoma closure was delayed at least 8 weeks to allow for chemotherapeutic effect. Uncomplicated TB responded rapidly to therapy. There were no deaths in this group. Thirty-seven of the 45 “medical” cases made an uncomplicated recovery on anti-TB therapy. Three died due to generalised disease, 5 had complications (chylous ascites 2, protein-losing enteropathy 3) and 3 had relapse of disease due to poor compliance. The morbidity and mortality of this ubiquitous disease can be greatly reduced by timely diagnosis, which often requires early recourse to diagnostic laparotomy, and appropriate surgery and supportive care for complicated disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00174332
Permalink
