Study on analysis of abdominal tuberculosis and its incidence in perianal fistulae at Madras Medical College

INTRODUCTION: Tuberculosis is one of the commonest disease known to mankind. There has been a trend of increased incidence of tuberculosis in human race in the last three decades. In most developing countries like India, it remains to be a major health hazard and major health related mortality and morbidity. Gastrointestinal Tuberculosis is one of the earliest known diseases which still remain the disease with diagnostic enigma due to its perplexing protean clinical manifestations. Importance of the condition lies in the diversity of the presentations and its wide spread effects on the body AIM OF THE STUDY: 1. To find out demographic profile of abdominal tuberculosis. 2. To study the clinical presentations of abdominal tuberculosis. 3. To evaluate the diagnostic modalities of abdominal tuberculosis. 4. To discuss the medical and surgical modalities of treatment of abdominal tuberculosis. MATERIALS AND METHODS: Patients with symptoms of Abdominal Tuberculosis were admitted and evaluated with various laboratory, radiological, laparoscopic methods. 50 patients who were diagnosed to have abdominal tuberculosis were selected. In those patients epidemiology, various clinical presentations, modalities used for diagnosis and different management strategies required were studied. RESULTS AND OBSERVATIONS: In our study, incidence was more in males compared to females. 2nd to 4th decades were more affected in both genders. Ascites was the most common presentation followed by abdominal mass and intestinal obstruction. Out of the lab investigations ESR and Ascitic Fluid Analysis were found to fetch positive results more often. Diagnostic Laparoscopy was the most sensitive investigation followed by CT Abdomen for diagnosis of abdominal tuberculosis. Peritoneal tuberculosis was the most common form. Management required (Medical or Surgical) were almost equal. More than two thirds patients required surgical correction in elective basis. Adhesiolysis was the common procedure done overall whereas Right Hemicolectomy was the commonest procedure in elective setting. Only one out of 50 patients of abdominal tuberculosis had associated perianal fistulae. CONCLUSION: Abdominal Tuberculosis is a diagnostic enigma due to its vague clinical manifestations. The diagnosis can remain inconclusive even after laboratory and radiological evaluation. To diagnose tuberculosis a high degree of clinical suspicion isneeded