Role of laparoscopy in the diagnosis and management of abdominal tuberculosis

Abstract

Background: Each year tuberculosis (TB) results in the death of 1.5 million people globally .The complexity of TB is clearly evident by noting that this disease primarily involved the lung now involves all organs and systems. Abdominal TB is one such complex presentation. The use of laparoscopy in the diagnostic work-up of suspected abdominal tuberculosis is underutilized in developing countries. Methods: The study of Role of laparoscopy in the diagnosis and management of abdominal tuberculosis was conducted in patients with clinically suspected abdominal tuberculosis but histologically or microbiologically unconfirmed tuberculosis at any other site. Patients satisfying inclusion criteria are subjected to diagnostic laparoscopy, biopsy of specimen from peritoneum , omentum, tissues, mesenteric lymph nodes for histopathological examination, AFB staining and cartridge based nucleic acid amplification test (CBNAAT) of peritoneal aspirates for confirmation of abdominal tuberculosis. Results: Total 38 cases were included in this study with a clinical and radiological diagnosis of suspected abdominal tuberculosis. All patients underwent diagnostic laparoscopy. Conclusions: Diagnostic laparoscopy avoids the morbidity and mortality of laparotomy in chronically ill patients, reduces the rate of misdiagnosis of other abdominal conditions and unnecessary long-term therapy. Diagnostic laparoscopy and tissue sampling is a viable and reliable strategy in patients with suspected abdominal tuberculosis.