Tạp chí Y học Thành phố Hồ Chí Minh, 9(3):161. DOI
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Nguyễn Văn Hải
Objectives: To describe some clinical features and to
evaluate early postoperative results of perforated tuberculous
enteritis.
Methods: Charts of all patients treated for perforated
tuberculous enteritis at NDGD hospital between 1999 and 2004 were
retrospectively reviewed. Definife diagnosis of perforated tuberculous
enteritis was based on surgical and histopathological findings.
Results:
There were 15 patients including 14 men and 1 woman with mean age of 39
years (range 20 to 82 years). Noticeable clinical manifestations were:
abdominal pain (steadily severe in 5 and insidious with exacerbation in
10 patients), fever above 38oC in 5, cachexia in 11, abdominal
tenderness and muscular guarding in 15, preoperative shock in 4
patients. 60% of patients had chest X-ray consistent with tuberculosis
and pneumoperitoneum was showed on plain abdominal films in the same
percentage. 6 patients had leukopenia and HIV was positive in 5
patients. In operation, perforations were found in ileum and ileocecal
region in 86.7% of cases. Postoperative morbidity and mortality rates
were 60% and 46.7% respectively.
Conclusions: Perforated tuberculous
enteritis is a grave complication with high morbidity and mortality. So,
it should be considered in differentiate diagnosis of causes of
peritonitis, especially in patients who had advanced pulmonary
tuberculosis and in HIV-infected patients.
