Intestinal tuberculosis still a diagnostic challenge for the present day surgeon in our set up

Background: mycobacterium tuberculosis has been an important cause of morbidity and mortality from ancient times to date. extra-pulmonary t. binvolves 11-16% of all patients of t.b. out of which 3-4% belong to abdominal tuberculosis. thus intestinal tuberculosis still maintains a diversity in its clinical presentation,difficulty in diagnosis,and widespread complications often marked by prolonged morbidity and mortality. methods: this one year study was done at lahore general hospital,lahore starting from 21st june 2015 till 31stjuly2016. all the patients presenting with signs and symptoms of abdominal tuberculosis in the surgical outpatient department and in the a/e department were included in the study. a total of 35 patients presented over one year period with intestinal tuberculosis. results: a total of 30 patients were included in the study 16(53.33%) were males and 14(47%) were females. all patients underwent exploratory laparotomy. out of 30 patients 24 patients (80%) had intestinal obstruction 6 patients (20%) had intestinal perforation. out of 24 patients a total of 11 patients (46%) underwent adhesiolysis. double loop ileostomy was made in 6(25%) patients. five patients underwent primary resection and anastomosis (21%). 2 patients underwent right hemicolectomy (8%) due to ileocaecal mass formation. all the 6 patients who had intestinal perforation underwent ileostomy. reversal of ileostomy of all patients was undertaken after 6 months of primary surgery and starting of att. out of 12 patients 8 patients recovered successfully (66.66%). conclusion: intestinal tuberculosis has a chronic onset,insidious course and bizarre presentation. no single test is still considered diagnostic for this purpose. h/p remains the gold standard which is not possible without laparotomy. diagnostic laparoscopy may become an important diagnostic tool in future. regarding surgical treatment adhesiolysis and ileostomy are still the most commonly used and safe treatment option in our set up.