A PROSPECTIVE COHORT STUDY OF INTESTINAL OBSTRUCTION DUE TO TUBERCULOSIS.

Amit Kumar Gupta; Aditya Anand; Sarfaraz  Nawaz; Mohtamim  Haider

doi:10.51168/sjhrafrica.v5i3.1136

Authors

Dr. Amit Kumar Gupta Assistant Professor, Department of General Surgery, Mata Gujri Memorial Medical College & Lion Seva Kendra, Kishanganj, Bihar, India.
Dr. Aditya Anand Assistant Professor, Department of General Surgery, Mata Gujri Memorial Medical College & Lion Seva Kendra, Kishanganj, Bihar, India.
Dr. Md Sarfaraz Nawaz Assistant Professor, Department of General Surgery, Mata Gujri Memorial Medical College & Lion Seva Kendra, Kishanganj, Bihar, India.
Dr. Md Mohtamim Haider Professor & HOD, Department of General Surgery, Mata Gujri Memorial Medical College & Lion Seva Kendra, Kishanganj, Bihar, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1136

Keywords:

Intestinal tuberculosis, Bowel obstruction, Clinicopathological profile

Abstract

Introduction

Intestinal tuberculosis-related bowel obstruction is notably prevalent in underdeveloped nations. This study aims to explore the factors leading to suboptimal patient outcomes and to detail the surgical treatments, clinicopathological features, and prognoses of tuberculous intestinal obstruction in affected communities.

Methods

The prospective cohort study spanned 15 months at MGMMC & LSK Kishanganj, involving 123 patients treated surgically for tuberculous intestinal obstruction. Ethical approval was secured from the relevant authorities. Data analysis was performed using SPSS version 17.0, employing techniques such as descriptive statistics, chi-square tests for categorical data, and multivariate logistic regression to identify predictors of surgical outcomes.

Results

The study comprised 123 tuberculosis-related intestinal obstruction patients. Men outnumbered women 1.8 to 1. The median was 11–67 years old. The average age was 21–30. HIV-positive individuals had a median CD4+ count of 225 cells/μl, with 26.3% additionally having pulmonary tuberculosis. 58.5% of patients underwent emergency surgery, and 41.5% had elective surgeries. The most common operative findings were small bowel strictures (72.9%), followed by bands and adhesions (16.9%).

An ileo-transverse anastomosis and right hemicolectomy were the most common surgeries at 55.9%. All patients received antituberculous drugs for a year after surgery. Surgical site infection (SSI) was the most common postoperative complication at 37.3% in 42.8%. HIV-positive status and low CD4+ count were the best predictors of SSI (p<0.001).

Conclusion

Tuberculous intestinal obstruction is highly prevalent and increases morbidity and mortality in the area, with patients often seeking help at advanced disease stages. Early diagnosis and effective treatment require heightened awareness, thorough evaluation, and proactive management.

Recommendation

Upon potential exposure to tuberculosis, it is critical to regularly monitor for symptoms, understand associated risks, and adhere to recommended preventative strategies.