6-hour surgery for abdominal TB performed on 28-year-old at SLG hospitals in Hyderabad

Hyderabad: A 28-year-old patient suffering from abdominal tuberculosis and intestinal malrotation was successfully treated after a six-hour surgery. The patient, from Palakollu in West Godavari district of Andhra Pradesh, underwent surgery by the doctors of SLG hospitals in Hyderabad.

According to consultant surgical gastroenterologist Dr Pavan Kumar, a patient who thought he had acute stomach discomfort and vomiting was actually suffering from abdominal tuberculosis and intestinal malrotation.

When the patient went to see a local doctor at his native place, he was told he needed an abdominal ultrasound and a CT scan, after which it was discovered that he had appendicitis.

They attempted to remove the appendix laparoscopically at first but eventually opted for an open procedure. However, because the patient’s condition was too weak, it was sutured and referred to a higher hospital. The patient was then sent to the SLG hospitals in Hyderabad.

“When we tested here, we discovered intestine malrotation. This is most common in newborns and young children. They vomit instantly after consuming anything. Rotation of blood vessels occurs as a result of intestinal malrotation. As a result, the blood supply is cut off, and the intestines gradually die. This is an unusual occurrence in young adults. The malrotation was not associated with volvulus in their case,” said Dr Pavan Kumar.

According to the doctors, the appendix was in the patient’s midline, and the small intestine was on the right side of the stomach, rather than the left. Abdominal tuberculosis caused the clumping of nearly all organs, including the large intestine, small intestine, gallbladder, and liver.

Six-hour operation

The doctors working on this case had to separate the organs, reposition them in their proper locations, and remove the appendix at the same time. These procedures made the operation last for more than six hours.

Dr Laxma Reddy, Dr Suman from the anaesthesia team, and Dr Srinivas from the ICU team contributed significantly to the success of the surgery.

“There could have been issues during the 10-day post-operative period. So, we kept him under observation for a few days and discharged him. He should be cautious for at least a month because the intestines are at a different location. If the patient is not attentive in the next weeks, there is a potential of constipation, vomiting, and other difficulties,” Dr Pavan Kumar said.

Explaining his health condition, the patient said, “I was looking quite normal, but occasionally experienced constipation, stomach pain, and vomiting. While I assumed it was a minor problem, it turned to be a major one.”

What is Abdominal Tuberculosis?

Abdominal tuberculosis (TB) affects the gastrointestinal tract of the body, affecting the peritoneum, the abdominal lymph nodes, and occasionally the intestine itself.

In rare cases, abdominal TB can also affect the kidney, liver, and pancreas.

Abdominal tuberculosis may affect adults and children and can be serious since it can cause complications such as acute blockage of the intestine or bowel rupture, which can be fatal in certain cases.

Causes

The main cause of abdominal tuberculosis is the ingestion of tuberculosis germs.

Tuberculosis can move from the lungs to the abdomen. It can be detrimental to one’s general well-being and will make it difficult to do everyday activities.

Symptoms

Abdominal TB should not be ignored. Symptoms can be:

- unintentional loss of weight

- persistent abdominal pain along with abdominal distention

- constipation

- loose motion with or without bleeding, which does not respond to routine medication

- fever

- diarrhoea

- anorexia

- a sensation of a mass in the abdomen