Role of Laparoscopy in Diagnosis of Abdominal Tuberculosis

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.