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Case Report Abdominal tuberculosis (ATB) in children poses a diagnostic challenge because of its nonspecific clinical features, often delaying the diagnosis. The annual incidence of tuberculosis (TB) is nearly 10.1 million, including around 1 million children [1]. It is estimated that worldwide, 239 000 children younger than 15 years die from TB in a year [2]. TB being endemic in India accounts for about a quarter of the global TB cases, the highest in the world [3]. We hereby report a case of intestinal obstruction in a 6 month old child secondary to abdominal koch’s. The child underwent jejunostomy for severe bowel adhesions, frozen pelvis and cocoon formation. Histopathology of omentum and mesenteric lymphnodes confirmed it to be abdominal tuberculosis. With parenteral nutrition and injectable antitubercular drugs(second line) for 7 weeks before stoma closure and 2 weeks later patient could be managed successfully and discharged on oral ATT(Anti tubercular treatment).We could successfully manage abdominal tuberculosis with jejunostomy(high output fistula) with second line injectable ATT and total parenteral nutrition.

Koch's Abdomen- Successful Management of Abdominal Cocoon with Jejunostomy and Second Line Antitubercular Drugs