FREQUENCY OF INTESTINAL TUBERCULOSIS IN PATIENTS WITH INTESTINAL PERFORATION PRESENTING TO SURGICAL EMERGENCY

Abstract

Background: Tuberculosis remains a global health emergency and a leading cause of death from infectious diseases. Intestinal tuberculosis, though treatable, can lead to life-threatening complications including intestinal perforation. Limited data exists on the frequency of intestinal tuberculosis in patients presenting with intestinal perforation to surgical emergency departments.

Objective: To determine the frequency of intestinal tuberculosis in patients with intestinal perforation presenting to surgical emergency.

Methods: This cross-sectional study was conducted at the Department of Surgery, Lady Reading Hospital, Peshawar in year of 2024. A total of 116 patients aged 18-65 years with intestinal perforation confirmed by CT scan were included using consecutive non-probability sampling. Patients with traumatic perforation, malignancy, and pregnancy were excluded. Intestinal tuberculosis was diagnosed through histopathological examination. Data was analyzed using SPSS version 23, with frequencies and percentages calculated for categorical variables and chi-square test applied for stratification analysis.

Results: Among 116 patients, 68 (58.6%) were male and 48 (41.4%) were female with a mean age of 42.3 ± 14.7 years. The majority (71 patients, 61.2%) were from rural areas. Intestinal tuberculosis was diagnosed in 21 patients, giving an overall frequency of 18.1% (95% CI: 11.8% - 26.2%). The frequency was higher in rural patients (21.1%) compared to urban patients (13.3%), and among patients from lower socio-economic backgrounds (25.0%) compared to middle class (15.4%) and upper class (14.3%). Diabetic patients showed a higher frequency (23.5%) compared to non-diabetic patients (15.9%), though these differences were not statistically significant.

Conclusion: Intestinal tuberculosis accounts for approximately one-fifth of all cases of intestinal perforation in our population. The increased occurrence among rural and lower socioeconomic groups underscores the importance of focused public health initiatives as well as maintaining a high clinical suspicion for tuberculosis in patients with intestinal perforation.