Role of Laparoscopic Peritoneal Biopsy in the Diagnosis of Peritoneal Tuberculosis. A Seven-Year Experience
A. Abdelaal, R. Alfkey, S. Abdelaziem, M. Abunada, A. Alfaky, W. H Ibrahim, A. Toro, I. Di CarloOriginal article, no. 3, 2014
The diagnosis of asymptomatic abdominal tuberculosis,without characteristic laboratory and radiologic findings, isdifficult. We therefore investigated the role of diagnosticlaparoscopy in patients with suspected peritoneal tuberculosis(PTB). Patients admitted to Hamad General Hospital, Qatar,who underwent laparoscopic peritoneal biopsy for suspectedPTB from January 2004 to December 2010 were retrospectivelyanalysed. Factors assessed included patient age, sex, symptoms,clinical signs, CT scan findings, laparoscopic findings andhistopathological diagnosis. A total of 41 patients, 33 males(80.5%) and 8 females (19.5%), of mean age 31 years, underwentlaparoscopic peritoneal biopsy for suspected PTB duringthe study period. Abdominal pain was the most commonpresenting symptom, observed in 33 (80.5%) patients.Computerized tomography (CT) of the abdomen showed ascitesin 37 patients (90%), bowel nodules in 22 (54%), peritonealthickening and nodules in 37 (90%) and enlarged mesentericlymph nodes in 11 (27%). The classical gross laparoscopicappearance of peritoneal tuberculosis was observed in 38patients (93%), whereas laparoscopic findings were normal in 3 patients (7%). Histopathological results confirmed granulomatousinflammation in 38 patients (93%). The sensitivity andspecificity of gross laparoscopic appearance in diagnosingperitoneal TB were both 100%. Two patients experiencedcomplications from laparoscopy (5%), but there were nolaparoscopy-related deaths. Laparoscopic peritoneal biopsy isa rapid and safe method of accurately diagnosing PTB.
