Clinical factors associated with surgical interventions in patients with intestinal obstruction caused by abdominal tuberculosis.

PURPOSE: Abdominal tuberculosis (TB), including Intestinal TB (ITB) and peritoneal TB (PTB), can cause intestinal strictures, leading to obstructions. However, the surgical indications for TB-related intestinal obstructions are yet to be established. This study investigates the clinical factors associated with these surgical interventions.

METHODS

Eighty-eight consecutive patients with ITB or PTB were enrolled in this study. The severity of abdominal TB was evaluated by the number of computed tomography (CT) findings of ascites, peritoneal nodules > 10 mm, intestinal wall thickening, and peritoneal or omental thickening.

RESULTS

Intestinal obstructions were diagnosed in 25 patients. The median duration of non-operative management was 11 (2-35) days, and 10 of the 25 patients required surgical intervention after non-operative management. The surgery group had a higher frequency of more CT features (70% vs. 13.3%, P = 0.0038) and a lower frequency of antitubercular therapy (ATT; 50% vs. 100%, P = 0.0075) than the non-surgery group. The severity of lung TB had no impact on the need for surgery and there was discrepancy between the chest and abdominal CT findings.

CONCLUSION

Long-term non-operative management may be required for abdominal TB and the need for surgical intervention is associated with the ATT and CT findings.