Abdomen agudo perforativo por tuberculosis intestinal.

Abstract

The gastrointestinal commitment is the six most frequent location of extrapulmonary tuberculosis. Often its acute complications constitute the main presentation form due to a late diagnosis.

Objectives: To review the presentation of gastrointestinal tuberculosis as perforative acute abdomen and surgical resolution.

Material and method: Case 1. A 31 year old female, with newly diagnosed pulmonary tuberculosis, discontinuous treatment. Two month later presents with peritonitis acute abdomen. Laparotomy is done being stated intestinal perforations. They performed resection and anastomosis terminal. The treatment with ant tuberculosis starts. Good evolution. Case 2. A 30 years male patient, HIV and pulmonary tuberculosis with discontinuous treatment. He was admitted with abdominal pain and generalized peritoneal reaction. Intestinal perforations is found at laparotomy. Biopsy and raffia intestinal is performed. Four days later suture dehiscence and new intestinal perforations are found. Resection and ileostomy is performed. It evolution with distress and death. In both cases histopathology confirmed intestinal tuberculosis.

Conclusions: Because of the nonspecific symptoms of intestinal tuberculosis, is common the diagnosis through their acute complications and these are potentially lethal especially in immunocompromised patients. The prompt treatment with anti tuberculosis drugs is the limiting in elective surgery in selected cases.