Tuberculous perforation of the bowel. A report of 8 cases.

Eight patients with tuberculous perforation of the bowel, representing 15% of all cases of intestinal tuberculosis, were seen over a 13-year period. A wide spectrum of presentations was encountered. A history of acute abdominal pain was not always obtained, but it could be the first indication of the presence of associated intestinal involvement in a patient receiving treatment for pulmonary tuberculosis. Free subdiaphragmatic air was detected radiologically in only 2 cases (25%). It is suggested that emergency surgery should be limited to dealing with only the perforated and any obviously obstructed bowel, and the advantages of delaying additional procedures are stressed. Despite the invariable accompanying suboptimal nutritional status and associated medical problems found in this group of patients, only 2 died.