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Does diverting ileostomy improve the outcome in children with tuberculous small bowel obstruction requiring surgical intervention?

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Abstract

Introduction

Abdominal tuberculosis is fairly common in children. The most common clinical presentation is bowel obstruction. Depending upon the presentation, the intestinal obstruction can be either managed conservatively or by operative intervention. There are various options in patients who undergo operative treatment. This study was undertaken to analyze the results of operative intervention with and without ileostomy.

Materials and methods

This is a retrospective study carried out over a period of 10 years on 32 children who were operated for small bowel obstruction due to abdominal tuberculosis. The patients were divided into two groups (A: with ileostomy and B: without ileostomy). The relevant data and the defined outcome measures were statistically analyzed.

Results

A total of 32 children with tuberculous bowel obstruction requiring surgical intervention were studied. The patient of group A had mean duration of postoperative ileus for 2.55 days, restoration of enteral feeding within mean period of 3.55 days and had a primary hospital stay for a mean period of 9.0 days. These outcomes when compared with group B patients were statistically significant.

Conclusion

In children with bowel obstruction due to tuberculosis, diverting ileostomy decreases the morbidity by allowing early return of enteral motility, early institution of feeding and first-line ATT and decreasing the primary hospital stay.

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References

  1. Cruz AT, Starke JR (2007) Clinical manifestations of tuberculosis in children. Paediatr Respir Rev 8:107–117

    Article  PubMed  Google Scholar 

  2. Shah I, Uppuluri R (2010) Clinical profile of abdominal tuberculosis in children. Indian J Med Sci 64:204–209

    Article  PubMed  Google Scholar 

  3. Gurkan F, Ozates M, Bosnak M, Dikici B, Bosnak V, Tas MA (1999) Tuberculous peritonitis in 11 children: clinical features and diagnostic approach. Pediatr Int 41:510–513

    Article  CAS  PubMed  Google Scholar 

  4. Ozbey H, Tireli GA, Salman T (2003) Abdominal tuberculosis in children. Eur J Pediatr Surg 13:116–119

    Article  CAS  PubMed  Google Scholar 

  5. Bajpai M, Nambhirajan L, Dave S, Gupta AK (2000) Surgery in tuberculosis. Indian J Pediatr 67(2 Suppl):S53-7

    PubMed  Google Scholar 

  6. Mimidis K, Ritis K, Kartalis G (2005) Peritoneal tuberculosis. Ann Gastroenterol 18:325–329

    Google Scholar 

  7. Lin YS, Huang YC, Lin TY (2010) Abdominal tuberculosis in children: a diagnostic challenge. J Microbiol Immunol Infect 43(3):188–193

    Article  PubMed  Google Scholar 

  8. Rodriguez L, Lado L (2006) CA-125, adenosine deaminase, and PCR for Mycobacterium tuberculosis in the diagnosis of peritoneal tuberculosis. Scand J Infect Dis 38:749–750

    Article  Google Scholar 

  9. Mishra D, Singh S, Juneja M. Enterolithiasis (2009) An uncommon finding in abdominal tuberculosis. Indian J Pediatr 76(10):1049–1050

    Article  PubMed  Google Scholar 

  10. Akhan O, Pringot J (2002) Imaging in abdominal tuberculosis. Eur Radiol 12:312–323

    Article  PubMed  Google Scholar 

  11. Andronikou S, Welman CJ, Kader E (2002) The CT features of abdominal tuberculosis in children. Pediatr Radiol 32:75–81

    Article  PubMed  Google Scholar 

  12. Rai S, Thomas WM (2003) Diagnosis of abdominal tuberculosis: the importance of laparoscopy. J R Soc Med 96:586–588

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Mirza B, Ijaz L, Saleem M, Sheikh A (2011) Surgical aspects of intestinal tuberculosis in children: our experience. Afr J Paediatr Surg 8:185–189

    Article  PubMed  Google Scholar 

  14. Kaushik R, Punia RP, Mohan H, Attri AK (2006) Tuberculous abdominal cocoon—a report of 6 cases and review of the literature. World J Emerg Surg 1:18

    Article  PubMed  PubMed Central  Google Scholar 

  15. Abbasi A, Javaherzadeh M, Arab M, Keshoofy M, Pojhan S, Daneshvar G (2004) Surgical treatment for complications of abdominal tuberculosis. Arch Iran Med 7:57–60

    Google Scholar 

  16. Badaoui E, Berney T, Kaiser L, Mentha G, Morel P (2000) Surgical presentation of abdominal tuberculosis: a protean disease. Hepatogastroenterology 47:751–755

    CAS  PubMed  Google Scholar 

  17. Ara C, Sogutlu G, Yildiz R, Kocak O, Isik B, Yilmaz S, Kirimlioglu V (2005) Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure. J Gastrointest Surg 9(4):514–517

    Article  PubMed  Google Scholar 

  18. Boukthir S, Mrad SM, Becher SB, Khaldi F, Barsaoui S (2004) Abdominal tuberculosis in children. Report of 10 cases. Acta Gastroenterol Belg 67:245–249

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery, J. N. Medical College, AMU, Aligarh, UP, India

    Rizwan Ahmad Khan & Imran Ghani

  2. Department of Radiodiagnosis, J. N. Medical College, AMU, Aligarh, UP, India

    Shagufta Wahab

Authors
  1. Rizwan Ahmad Khan
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  2. Shagufta Wahab
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  3. Imran Ghani
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Corresponding author

Correspondence to Shagufta Wahab.

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Since it was a retrospective study, ethical clearance was not required.

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Khan, R.A., Wahab, S. & Ghani, I. Does diverting ileostomy improve the outcome in children with tuberculous small bowel obstruction requiring surgical intervention?. Pediatr Surg Int 33, 1215–1219 (2017). https://doi.org/10.1007/s00383-017-4169-1

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  • DOI: https://doi.org/10.1007/s00383-017-4169-1

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