The Pediatric Corner: Spontaneous Tuberculous Enteroumbilical Fistulas

Gastrointestinal tuberculosis in children is an uncommon condition. Obstruction and hemorrhage are the known common complications of tuberculous enteritis. Perforation is an uncommon complication whereas tubercular enterocutaneous fistula is a still rarer complication. Five children with spontaneous tubercular enteroumbilical fistulas are being reported. All were below the age of 10 years, the youngest being 15 months old. Four children had conservative treatment with antitubercular drugs and one had exploration, resection of gut and excision of fistula. All the children who had conservative treatment survived whereas the child who underwent surgery died in the postoperative period. We feel that the conservative management is the treatment of choice in cases of established tubercular enterocutaneous fistulas.