CASE OF DUODENAL FISTULA WITH DELAYED HEALING IN PATIENT WITH TUBERCULOSIS AFTER BLUNT ABDOMINAL TRAUMA

Tuberculosis has estimated case of 99,00,000 worldwide and 25,90,000 in india.Deaths due to tuberculosis is 12,80,000 worldwide and 4,93,000 in india.1 Abdominal TB constitutes 12% of all extrapulmonary tuberculosis cases and is one of the most common forms of extrapulmonary TB.2 Duodenal perforation following blunt abdominal trauma is an extremely rare and often overlooked injury leading to increased mortality and morbidity.4,5,6 34 year old male patient presented with complaint of abdominal pain with rigid abdomen and CECT abdomen and pelvis showed retropneumoperitoneum with pneumoperitoneum. Emergency exploratory laparotomy done and duodenal perforation of size 3*3 cm2 size repaired with retrograde duodenostomy and feeding jejunostomy. Duodenal perforation leaked after 3 days and persistent bilious drain output from right side of drain kept in morrison pouch. Difficulty in treatment was maintaining nutrition, hydration and treatment of tuberculosis with duration of 44 days and readmitted for enterocutaneous fistula with significant weight loss for duration of 1 month.