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Category: Volume 06 Issue 09 September 2018
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Title: Role of Laparoscopy in Diagnosis of Abdominal Tuberculosis

Authors: Zahoor Ahmad Bhat, Mumtaz-Ud-Din Wani, Aadil Majeed Bhat

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.89

Abstract

Background: Diagnosis of abdominal tuberculosis is difficult as well as its Histopathological confirmation because of suboptimal, noninvasive access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneum.

Aim: To evaluate the potential benefits of laparoscopy with tissue biopsy in the diagnosis of suspected abdominal tuberculosis

Methods: A prospective hospital based study of 50 patients with suspicion of abdominal tuberculosis after clinical examination and baseline investigations from November 2013 to November 2015 was done in the Postgraduate Department of Surgery, Government Medical College,  Srinagar.

Abdominal tuberculosis was diagnosed in 80% of these patients. A descriptive analysis of data collected from case records of the patients was done to study the clinical characteristics, laboratory, radiological and histological findings along with usefulness of laparoscopy to confirm the diagnosis of abdominal tuberculosis.

Results: Laparoscopy was performed in 50 patients of chronic abdominal pain with unsettled diagnosis. Laparoscopically guided peritoneal biopsies revealed the following   histopathological reports: Chronic granulomatous inflammation (caseating and non-caseating) in 80% of the patients. Metastatic adenicarcinoma in 14% of the cases. Normal report in 6%.

Conclusions: Early laparoscopy is safe and useful in establishing the diagnosis of peritoneal TB in suspected cases resulting in avoiding expensive, time consuming and sometimes fruitless investigations and allowing early institution of treatment.

Keywords: Laparoscopy, Abdominal tuberculosis, Chronic abdominal pain, Nonspecific abdominal pain, Ascites.

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Corresponding Author

Dr Zahoor Ahmad Bhat

Sr. Resident, Department of surgery, Govt. Medical College, Srinagar, India

Postal Adress: 117, Sirnoo, Tehsil & District: Pulwama, Pin Code: 192301