title: Abdominal tuberculosis with an acute abdomen: our clinical experience.
abstract: BACKGROUND
  Tuberculosis is an important cause of morbidity in India. Abdominal Tuberculosis is a great mimicker and is difficult to diagnose. This prospective observational study is based on those patients who were diagnosed to be suffering from Abdominal Tuberculosis only after they presented with an acute abdomen. This study aims to document the nature of different types of acute presentation in Abdominal Tuberculosis according to involved sites and surgical pathology. The study also discusses the indications and extent of surgical intervention.
  
  
  METHODS
  Seventy new cases of Abdominal Tuberculosis (out of 718 cases of acute abdomen) were diagnosed and treated over a period of three years in the surgical ward of Calcutta National Medical College. Macroscopic appearance of abdominal tissues during surgery suggested the diagnosis of tuberculosis. The diagnosis was confirmed by histopathology and tissue culture. All patients were subsequently treated with a full course of antitubercular drugs (ATD).
  
  
  RESULTS
  The clinical presentations of acute abdomen included acute intestinal obstruction, perforative peritonitis and acute appendicitis etc. Terminal ileum and ileocaecal region were predominantly involved. The most common pathology was intestinal stricture with or without perforation. Most of the patients (approx 78.5%) required emergency surgery as a therapeutic intervention. A two-stage procedure was preferred in peritonitis and sepsis. Most of the remaining patients (12.8%) required surgery after initial conservative treatment for the first few days. Undiagnosed Abdominal Tuberculosis represents a notable percentage (10%) of patients who present with an acute abdomen as a surgical emergency.
  
  
  CONCLUSIONS
  Abdominal Tuberculosis is very difficult to diagnose and diagnosis is often delayed till an acute abdomen is presented with. Almost all patients needed surgical intervention. Irrespective of surgery, all patients of abdominal tuberculosis require a full ATD.
authors.affiliation: Assistant Professor, Department of General Surgery, Calcutta National Medical College , Kolkata, India .
authors.forename: Arunima
authors.initials: A
authors.lastname: Mukhopadhyay
authors.affiliation: Professor, Department of General Surgery, Calcutta National Medical College , Kolkata, India .
authors.forename: Ramprasad
authors.initials: R
authors.lastname: Dey
authors.affiliation: Associate Professor, Department of Obstetrics & Gynaecology, Bankura Sammilani Medical College , Kolkata, India .
authors.forename: Ujjwal
authors.initials: U
authors.lastname: Bhattacharya
keywords: Abdominal tuberculosis with acute abdomen; Acute presentations of abdominal tuberculosis