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Background: Surgical management of intestinal tuberculosis is a crucial task in preoperatively unsuspected cases. Objective: The present study was undertaken to see the different surgical management of intestinal tuberculosis in preoperatively unsuspected cases. Methodology: This clinical trial was conducted in different units of the Department of Surgery at Dhaka Medical College Hospital, Dhaka from March 2002 to March 2004 for a period of two (2) years. Purposive sampling technique was applied to collect the study population. Patients with no suspicion about pulmonary as well as intestinal tuberculosis, history of cough & hemoptysis, no history of antitubercular drug taken, diagnosed as other than tuberculosis, per operative suspicion raised by any one or more of followings, enlarge lymph nodes in mesentery, omental masses, ileocaecal masses, suspicious growth in ileum, omental thickening, perforation suspected by tuberculosis were selected as study population. Biopsy was taken from suspicious lesions. Histopathology was confirmed the granulomatous lesion. Results: A total number of 300 patients were undergone surgical intervention of which 38(12.7%) cases. Maximum affected age group was 21 to 30 years which was 16(42%) cases. Granulomatous inflammation was found in 12(31.6%) cases. Maximum mode of presentation was in the form of emergency which was 36(94.7%) cases. Tissue was taken for biopsy from mesenteric lymph node in 16(42.10%) cases. Procedures done during laparotomy were resection of ileum and ileoileal anastomosis and proximal ileostomy which was performed in 6(23.07%) cases, resection of ileum and ileostomy in 5(19.23%) cases and resection of ileum with ileoileal anastomosis in 3(11.53%) cases. Conclusion: In conclusion surgical management is performed by resection of jejunum with jejunojejunal anastomosis, hemicolectomy with ileotrasverse anastomosis and resection of ileum with ileostomy.

Surgical Management of Intestinal Tuberculosis in Preoperatively Unsuspected Cases at a Tertiary Care Hospital in Dhaka City