ROLE OF STRICTUREPLASTY IN THE MANAGEMENT OF TUBERCULOUS STRICTURES OF SMALL INTESTINE

Tuberculous Strictures of Small Intestine

Abstract

Objective: To evaluate the outcome and assess the reliability of strictureplasty in the management of small intestinal strictures due to tuberculosis.

Design: A retrospective observational and descriptive study.

Place and Period of Study: PNS-Shifa, Karachi. Clinical data of cases of intestinal tuberculosis reporting over a period of five years-(Aug 1999-to-Aug 2004) was studied.

Subjects and Methods: Thirty patients with small intestinal tuberculosis who underwent strictureplasty alone or in combination with limited resection were selected for the study.

Results: In 20 cases (66.67%) the strictureplasty was performed in combination with limited resection.  Remaining 10 cases (33.33%) were managed by strictureplasty alone.   Anastomotic leakage with fistula formation occurred in 3 cases (10%), Burst abdomen   occurred in 2 cases (6.67%). Sub-diaphragmatic abscess formation occurred in 3 cases (10%). On prolonged follow-up averaging two years, re-admission was required in 5 cases (16.67%). Re exploration to relieve obstruction due to adhesions was required in 2 cases (6.67%). Late incisional hernia was seen in 4 cases (13.33%). There was no procedure related mortality.

Conclusion: Strictureplasty is a simple, quick, and safe operative technique to manage tuberculous small intestinal strictures, in combination with limited resection or as a sole procedure.