CASE STUDY: NUTRITIONAL MEDICAL THERAPY IN A PATIENT WITH INTESTINAL TUBERCULOSIS, SEVERE MALNUTRITION, AND CACHEXIA WHO UNDERWENT LAPAROTOMY AND LOOP ILEOSTOMY CREATION

Intestinal tuberculosis (TB) is a rare form of extrapulmonary tuberculosis that is often associated with severe malnutrition and cachexia due to impaired nutrient absorption, chronic inflammation, and reduced food intake. This case study describes a 31-year-old female patient diagnosed with intestinal tuberculosis complicated by severe malnutrition and cachexia. The patient was admitted with worsening abdominal pain, nausea, vomiting, significant weight loss (31% within six months), and poor nutritional intake. Initially suspected of having an intra-abdominal tumor, the patient underwent exploratory laparotomy, adhesiolysis, and loop ileostomy. Postoperative findings confirmed intestinal tuberculosis with ileal, omental, and cecal adhesions. Nutritional management was initiated using a combination of parenteral and enteral nutrition, followed by a gradual transition to oral feeding according to the patient’s clinical condition and tolerance. Nutritional intake, ileostomy output, and laboratory parameters were continuously monitored throughout hospitalization. The patient demonstrated progressive clinical improvement, increased tolerance to nutritional intake, successful transition to oral feeding, and enhanced postoperative recovery. Nutritional support contributed to wound healing, stabilization of nutritional status, and overall recovery. The patient was discharged after 15 days of hospitalization with anti-tuberculosis therapy and nutrition counseling. Individualized medical nutrition therapy is essential for patients with intestinal tuberculosis complicated by severe malnutrition and cachexia undergoing surgery. Appropriate perioperative nutritional support, continuous monitoring, and nutrition education can improve recovery and clinical outcomes.