“COMPARATIVE STUDY OF CONSERVATIVE VERSUS OPERATIVE MANAGEMENT IN CASES OF ABDOMINAL KOCH'S”

Abstract

Background: Abdominal tuberculosis is sixth most common type of extra- pulmonary tuberculosis. It can affect any intra-abdominal organ and any part of the intestinal tract. Patients are managed conservatively and Surgery in patients with Abdominal Tuberculosis is reserved for those with acute surgical complications including intestinal obstruction, perforation, abscess, colocutaneous stula, excessive bleeding and patients who are not responding to medical management. Our study was conducted on 65 Patients of abdom Methods: inal tuberculosis admitted in department of general surgery RD Gardi Medical College, Ujjain between December 2019 to July 2021. Out of 65 patients, 66.2% were managed Results: surgically and 33.8% managed conservatively. Exploratory laparotomy With Segmental Bowel Resection due to multiple ileal strictures with ileostomy with ileostomy closure after 3 months of ATT is done in 30.23% patient in our study. Exploratory laparotomy with loop ileostomy for ileocaecal mass and abdominal abscess 2ndstage surgery after 3 months of ATT right hemicolectomy with ileotransverse anstomosis done in 20.93 % patients. Exploratory laparotomy With Resection Of ileocaecal Mass with ileoascending anastomosis is done in 20.93% of patients in our study In our study, exploratory laparotomy with adhesiolysis with release of bands with loop ileostomy. 2ndstage surgery done after 3 months of ATT, reexploration with right hemicolectomy with ileotransverse anastomosis done in 11.62 % patients.Exploratory laparotomy with right hemicolectomy with ileotransverse anastomosis is done in 10.76 % patients.In our study, slight seroma discharge from wound site is the most common complication seen post operatively (35%). In our study, fecal stula is seen only in 5% of patients. In our study, there are complications developed during and after ATT in which 6 patients required surgery Abdominal tuberculos Conclusions is is an increasingly common disease that poses diagnostic challenge despite advances in diagnostic modalities, as the symptoms and signs of the disease are nonspecic, which may lead to diagnostic delays and eventually lead to development of complications. Therefore, a high index of suspicion is an important factor in early diagnosis. Patients are managed conservatively and Surgery in patients with Abdominal Tuberculosis is reserved for those with acute surgical complications.