Value of diagnostic laparoscopy in tuberculous peritonitis.

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.