Tuberculous perforation of the small bowel

Aston, N. O.; Costa, Alan de

doi:10.1136/pgmj.61.713.251

Cited by 14 publications

(16 citation statements)

References 7 publications

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“…However, direct closure of the perforation with or without bypass is generally associated with poorer results. [45] Resection and anastomosis is therefore recommended, [46] especially if combined with postoperative anti-tubercular therapy. [47][48][49] However, regardless of the surgical procedure, the mortality rate is relatively high, ranging from 30% [45,46] to 60%.…”

Section: Discussionmentioning

confidence: 99%

“…[45] Resection and anastomosis is therefore recommended, [46] especially if combined with postoperative anti-tubercular therapy. [47][48][49] However, regardless of the surgical procedure, the mortality rate is relatively high, ranging from 30% [45,46] to 60%. [12] This high rate of mortality is principally due to the poor clinical perioperative conditions of patients undergoing surgery.…”

Section: Discussionmentioning

confidence: 99%

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Tubercular bowel perforation: what to do?

Catena

Ansaloni²,

Lazzareschi³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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AMAÇAbdominal tüberküloz (TB) insidansı, Batı ülkeleri ile gelişmiş ülkelerde artmaktadır. Bu patoloji, serbest intestinal perforasyonu da içeren birkaç komplikasyona sahiptir. Bu çalışmanın amacı, tüberkülozla ilişkili perforasyonlara yö-nelik çeşitli tedavileri tartışan ilgili tüm literatürü analitik olarak özetlemektir. GEREÇ VE YÖNTEMBologna Üniversite Hastanesi Acil Servis Departmanı'nın son 13 yıldaki kayıtlarını sorgulayan hasta veritabanı göz-den geçirildi. 3 Mart 2009 tarihine kadar bildirilmiş olan intestinal TB'ye bağlı raporlanan bütün intestinal perforasyonu olguları geriye dönük olarak değerlendirildi. BULGULARİntestinal perforasyon ile başvuran 119 abdominal tüberkü-loz olgusu yayınlanmıştır. Cerrahi tedavi ile ilgili standardize kılavuzlar bulunmamaktadır. Bildirilen 119 olgudan, 40'ı (%33,6) rezeksiyon ve anastomozla, 17'si (%14,2) doğrudan dikişlerle, 4'ü (%3,3) basit bir drenle tedavi edilmiş ve 57 olgunun tedavisi de rapor edilmemiştir. SONUÇTB'ye bağlı bağırsak delinmelerinin cerrahi tedavisi için en uygun stratejiyi analizle ayırt edilecek hiçbir klinik kanıt saptanmadı. Perforasyonun doğrudan kapatılması, tipik olarak yüksek morbidite ve mortaliteyle korelasyon gös-termektedir. Perfore kısmın rezeksiyonu ile birlikte anastomoz gerçekleştirilmesi daha iyi tedavi gibi görünmekte-dir. Yine de, farmakolojik tedavi, tedavinin esas ayağı olarak kalmaya devam etmektedir.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tubercular bowel perforation: what to do?

Catena

Ansaloni²,

Lazzareschi³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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“…Recently, vasculitis of the mesenteric vasculature due to tuberculosis has been implicated as a contributory factor 8 . The mesenteric vasculature (medium and small vessels, mostly) and endarteritis of sub-mucosal vessels was frequently involved by granulomatous inflammation, with intravascular organizing thrombus being present in 30.0% of the resected specimens with perforation [9][10] . Multiple perforations occur in 40.0% of patients and are associated with poor prognosis 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Rationale most of the guidelines on the treatment of tuberculosis suggest that 6 months treatment is sufficient for abdominal tuberculosis [10][11] . In a randomized controlled trial, Balasubra-maniam et al 11 reported no difference in success rate of 6 months (99.0%) versus 12 months (94.0%) anti-tuberculous drugs (conventional strategy) in the treatment of abdominal tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

Rima

Naser

Kabir³

et al. 2017

Bangladesh J. Infect. Dis.

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A 18 years old boy presented with severe diffuse abdominal pain, constipation, abdominal distention, fever and diagnosed as a case of perforation as free gas noted under both dome of the diaphragm. After resuscitation, exploratory laparotomy was done and diagnosed as a case of multiple spontaneous leaky perforations of jejunum and ileum 25 to 30 cm from duodeno-Jejunal flexure (DJ) up to terminal ileum. Peritoneal toileting and excisional biopsy of the mesenteric lymph node were done. Operative and postoperative period were uneventful. Histopathological examination of the resected lymph node revealed granulomatous inflammation compatible with tuberculosis. Anti-tubercular therapy was started and continued for 6 months. Patient was discharged on the 12 th postoperative day in a good condition. At 3 months of follow up the patient was asymptomatic and thriving well. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. [Bangladesh Journal of Infectious Diseases 2016;3(2):52-54]

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“…The most common site of intestinal perforation is the terminal ileum because of its high absorptive rate, close contact of the bacilli with mucosa, the presence of abundant lymphoid tissue, and being a region of physiologic stasis [5, 6]. In majority of cases (approximately 90%), only a single perforation is present [7], but multiple perforations at a single site such as the jejunum or the ileum have also been reported as well [1]. …”

Section: Discussionmentioning

confidence: 99%

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

Masood

Majid

Rafiq

et al. 2015

Case Reports in Surgery

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Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.

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Tuberculous perforation of the small bowel

Abstract: Summary Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended.

Cited by 14 publications

References 7 publications

Tubercular bowel perforation: what to do?

Tubercular bowel perforation: what to do?

Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

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