Conservative management of tubercular intestinal obstruction with antitubercular drugs and steroid

Abstract

Objective: Tubercular intestinal obstruction is a challenging condition often necessitating surgical intervention. This case study aims to evaluate the effectiveness of conservative management, including antitubercular therapy, short-course steroids, and dietary modifications, in resolving acute and complete intestinal obstruction caused by tuberculosis. Case Description: A 17-year-old malnourished male presented with acute abdominal pain, vomiting, and constipation. Imaging revealed mid-ileal intestinal obstruction due to tuberculosis. Conservative management, involving intravenous antibiotics, nasogastric decompression, steroids, and antitubercular treatment, led to gradual resolution. The patient experienced recurrent partial obstruction episodes, each managed conservatively with antibiotics, steroids, and dietary adjustments. A slow transition from liquid to solid diet accompanied recovery. After a year of treatment, the patient achieved recovery with weight gain. Conclusion: Tubercular intestinal obstruction, challenging to treat medically, often requires surgery. However, this case demonstrates the successful outcome through a comprehensive conservative approach. The inclusion of steroids alongside antitubercular treatment played a crucial role. Additionally, a cautious transition from liquid to solid diet post-resolution proved effective in preventing recurrence. Conservative management, when tailored to the patient's nutritional needs and disease course, can lead to favorable outcomes in tubercular intestinal obstruction.