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: The aim is to analyze our experience with diagnostic laparoscopy in diagnosis of abdominal tuberculosis and to review the literature for the role and importance of laparoscopy in the diagnosis of condition. Materials and Methods: A retrospective study on 13 patients refers to surgeons from medical department at King Fahad Medical City for diagnostic laparoscopy for clinically suspected abdominal tuberculosis/Crohn disease in 3 years period. A video record diagnostic laparoscopy was performed in all patients with peritoneal biopsy, the clinical data regarding the presenting symptoms, blood and radiological investigations together with the laparoscopic finding and the pathological finding were reviewed. Results In all patients blood tests, imaging, and ascitic fluid culture failed to confirm the diagnosis of abdominal tuberculosis while diagnostic laparoscopy with peritoneal biopsy confirmed the diagnosis in 11 patients. One patient was found to have disseminated Adenocarcinoma; anther patient had non specific inflammation. Conclusion: diagnostic methods of TB such as imaging, culture of ascitic may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. Introduction Tuberculosis (TB) is a re emerging global emergency which is further complicated by AIDS/HIV infection and the use of immunosuppressant drugs. Prompt diagnosis allows an early start to anti-TB therapy, with advantages for the patient and savings to the health system. We studied of 13 of suspected abdominal tuberculosis to evaluate the role of laparoscopy in establishing the diagnosis of the disease. Materials and Methods We retrospectively reviewed patient records and video recordings of patients who underwent video recorded diagnostic laparoscopy and peritoneal biopsy for suspected abdominal tuberculosis in the period from October 2004 to January 2008 at King Fahad Medical City Riyadh ,Saudi Arabia, With special emphasis on clinical presentation, investigations, visual laparoscopic appearance and histological results of peritoneal biopsies.Laparoscopic techniqueLaparoscopy was done under general anesthesia in all patients. The first trocar (10mm) was introduced by open method in all patient in the subumblical region to avoid bowel injures due to adhesions. A second 5 mm trocar introduced under direct vision in the right sub costal region in the mid clavicular line. 50 ml of ascetic fluid aspirated for Zeil Nelson staining, culture and cytology.3 or 4 peritoneal biopsies taken by sharp biopsy forceps (figure 1) from different sites of the peritoneum and sent for histology examination. Trocars sites were closed with non absorbable sutures.
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