EP.FRI.56 Spectrum of Clinical Presentation, Radiological Findings and Management of Tuberculosis on the Surgical Floor - An Experience from a Tertiary Care Hospital in Pakistan

Abstract Aim Abdominal tuberculosis has varied presentation and can be confused with other conditions. The aim of the study is to assess and evaluate various clinical presentations and management of intestinal tuberculosis presenting to our tertiary care hospital. Methods This 3-year descriptive study was conducted on patients with diagnosed intestinal tuberculosis (by histopathology) in Surgical Unit-II, from Jan 2017 to Jan 2020. Detailed history and clinical examination were performed in all the cases. Investigations like Blood CP and ESR, Albumin, Ultrasound abdomen, X-Ray abdomen were carried out in all the cases. Preoperative assessment of anatomical site and variety of lesions were also noted. Per-operative findings and procedure performed was recorded. Results A total of 85 patients with diagnosis of intestinal tuberculosis were admitted and operated. Diagnosis was confirmed by histopathology. Among these, 35 (40.7%) were male, and 50 (59.3%) were female. Variable clinical presentations were seen. Majority of patients 76(89.3%) had abdominal pain 55 (64.8%) had vomiting. Most common per-op findings included strictures 42 (50%), intestinal perforation 35 (40.7%) and multiples tubercles in abdomen 24 (28.7%). Most common procedures performed were ileostomy 45 (52.8%) and right hemicolectomy 28 (33.3%). X ray and Ultrasound findings were positive in 79(91.6%) and 67 (79.6%) cases only respectively. Conclusion High clinical suspicion is required for diagnosis of TB. Intestinal perforation, and strictures were the commonest lesions. Definitive surgical procedure like ilecolostomy and right hemicolectomy are the main surgical options.