İBRAHİM TAÇYILDIZ, ŞÜKRÜ BOYLU, GÜLŞEN YILMAZ, NEDİM ABAN
Dicle Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, DİYARBAKIR
This report consists of our 8 years experience about abdominal tuberculosis, and evaluation of the methods of diagnosis and treatment of the illness which has increased recently. The extra pulmonary forms of tuberculosis especially abdominal tubercuiosis, is still a problem in our country as in other developing countries (1, 2, 3, 4, 5, 6).
Forty-six patients; 25 male (4,3%) and 21 female (45.7%), who were operated with the diagnosis of abdominal tuberculosis over a 8 year period, were evaluated respectively according to these criterions; age, sex, history, physical examination and laboratory findings, methods of diagnosis and treatment, morbidity and mortality rates.
Forty-one (89.1%) patients-17 (37.0%) of required emergency surgery- underwent laparotomy while in 5 (10.9%) of them percutaneous drainage was applied. In 25 cases (54.3%) intestinal tuberculosis and in 21 cases (45.7%) tuberculous peritonitis was observed. It was seen that intestinal form was commonly located in terminal ileum, History, physical examination, laboratory findings, radiological examination were-commonly inadequate for diagnosis. Infection agent was often mycobacterium bocis. There was active pulmonary tuberculosis only in 13% of the patients. The problem most frequently requiring surgery was intestinal obstruction. Mortality rate after emergency surgery was 23.5% and overall mortality rate was 10.8%.
It was seen that most of the patients had no pulmonary tuberculosis. We observed that laparotomy is the most reliable method for diagnosis, though physical examination and laboratory findings are useful. Limited resection and by-pass procedures are often sufficient in surgical treatment. We think that early diagnosis and treatment with a careful approach, will bring down the complications occuring during treatment so that mortality rates will decrease significantly.
Keywords: ABDOMINAL TUBERCULOSIS, PERITONITIS, INTESTINAL TUBERCULOSIS