The European journal of surgery = Acta chirurgica · 1999
Value of diagnostic laparoscopy in tuberculous peritonitis.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Apaydin B, Paksoy M, Bilir M, Zengin K, Saribeyoglu K, Taskin M
Аннотация
OBJECTIVE: To assess the safety and efficacy of diagnostic laparoscopy in patients with tuberculous peritonitis.
DESIGN: Retrospective clinical study.
SETTING: University hospital, Turkey.
SUBJECTS: 8 patients (2 women, 6 men; mean age 26 years) who presented with tuberculous peritonitis between January 1994 and January 1996.
INTERVENTION: Laparoscopy under local anaesthesia with sedation (the 4 who presented with ascites) and laparotomy (the 4 who presented with an acute abdomen).
MAIN OUTCOME MEASURES: Clinical and laboratory findings, biochemical and microbiological analysis of ascites, histopathological examination of specimens, morbidity, and mortality.
RESULTS: 4 patients presented with ascites, and 4 with adhesions. Ascites; adhesions between liver and diaphragm, liver and intestines, and intestines and the abdominal wall; miliary nodes on the peritoneal surface; and inflamed haemorrhagic areas on the peritoneum could all be seen at laparoscopy. One of the 8 patients who underwent laparotomy developed a spontaneous enterocutaneous fistula during the early postoperative period. Two of eight patients died, one of an early enterocutaneous fistula and the other of cor pulmonale 3 1/2 months later. The remaining 6 patients survived without complications after antituberculous medical treatment.
CONCLUSIONS: Laparoscopy is a safe and accurate method of diagnosis of tuberculous peritonitis.
DESIGN: Retrospective clinical study.
SETTING: University hospital, Turkey.
SUBJECTS: 8 patients (2 women, 6 men; mean age 26 years) who presented with tuberculous peritonitis between January 1994 and January 1996.
INTERVENTION: Laparoscopy under local anaesthesia with sedation (the 4 who presented with ascites) and laparotomy (the 4 who presented with an acute abdomen).
MAIN OUTCOME MEASURES: Clinical and laboratory findings, biochemical and microbiological analysis of ascites, histopathological examination of specimens, morbidity, and mortality.
RESULTS: 4 patients presented with ascites, and 4 with adhesions. Ascites; adhesions between liver and diaphragm, liver and intestines, and intestines and the abdominal wall; miliary nodes on the peritoneal surface; and inflamed haemorrhagic areas on the peritoneum could all be seen at laparoscopy. One of the 8 patients who underwent laparotomy developed a spontaneous enterocutaneous fistula during the early postoperative period. Two of eight patients died, one of an early enterocutaneous fistula and the other of cor pulmonale 3 1/2 months later. The remaining 6 patients survived without complications after antituberculous medical treatment.
CONCLUSIONS: Laparoscopy is a safe and accurate method of diagnosis of tuberculous peritonitis.