Role of diagnostic laparoscopy in suspected abdominal tuberculosis

Authors

  • Ashwani Gupta Professor and Head (Formerly Professor and Consultant, Department of Surgery, VMMC and Safdarjung Hospital), New Delhi, India https://orcid.org/0000-0003-0174-0169
  • Nikhil Prasad Resident Mch, Department of Plastic Surgery IMS BHU, Varanasi, Uttar Pradesh, (Formerly PG, Department of General Surgery, VMMC and Safdarjung Hospital), New Delhi
  • Vaishali Shirale Assistant Professor, Department of Surgery, ESIC Medical College and Hospital, Faridabad, Haryana https://orcid.org/0000-0002-7311-4338
  • Neha Dubey Assistant Professor, Department of Microbiology, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh
  • Indu Bhushan Dubey Associate Professor, Department of Surgery, VMMC and Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.3126/ajms.v13i5.42908

Keywords:

Tuberculosis, Acid fast bacilli, Bacillus-calmette guerin, Computed tomography, Abdominal tuberculosis, Diagnostic laparoscopy

Abstract

Background: The difficulty in confirming the diagnosis, morbidity and mortality associated with laparotomy in patients with abdominal Tuberculosis (TB) has generated interest in laparoscopy to obtain specimens for histological and microbiological assessment.

Aims and Objectives: Difficulty in sample procurement, paucibacillary load and non-specific clinical, biochemical, and radiological features makes early diagnosis difficult in abdominal TB. Diagnostic laparoscopy with peritoneal biopsy can provide rapid and correct diagnosis of abdominal TB and reduce significant morbidity and mortality.

Materials and Methods: Laparoscopy with umbilical port enabled direct inspection of peritoneum, intra-abdominal organs and facilitated obtaining biopsy specimens, cultures, and aspiration.

Results: Diagnostic laparoscopy has an important role not only in diagnosing abdominal TB, but also to rule out TB in certain cases. In our study, mesenteric lymphadenopathy was present in 85% of cases, tubercles in 63% and adhesions in 73%. An alternative diagnosis was established in 6 suspected abdominal TB patients (20%) who were microbiologically confirmed TB negative.

Conclusion: The study showed the feasibility of diagnostic laparoscopy in diagnosis of abdominal TB by sampling macroscopically visible pathological tissue with a low complication and conversion rate in most patients with suspected TB, and also providing an alternative diagnosis.

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Published

2022-05-03

How to Cite

Gupta, A. ., Prasad, N., Shirale, V., Dubey, N., & Dubey, I. B. . (2022). Role of diagnostic laparoscopy in suspected abdominal tuberculosis. Asian Journal of Medical Sciences, 13(5), 154–160. https://doi.org/10.3126/ajms.v13i5.42908

Issue

Vol. 13 No. 5 (2022)

Section

Original Articles

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Copyright (c) 2022 Asian Journal of Medical Sciences

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