Sharma's hanging gall bladder sign: A new sign for abdominopelvic tuberculosis: An observational study

Abstract

Background: Abdominopelvic tuberculosis (TB) involves genital tract, peritoneum, intestines, mesentery, omentum, abdominal lymph nodes, liver, and gall bladder and causes multiple adhesions of intestine and omentum with the anterior abdominal wall. Objective: To study the laparoscopic findings in abdominopelvic TB with special emphasis on new hanging gall bladder sign. Materials and Methods: A total of 10 cases of abdominopelvic TB diagnosed by demonstration of AFB on microscopy or culture on endometrial or peritoneal biopsy or positive epitheloid granuloma on biopsy or positive polymerase chain reaction to Mycobacterium TB on endometrial or peritoneal biopsy were included in the study. Laparoscopic visualization was done of all abdominopelvic TB cases. Results: Tubercles were observed in all 10 (100%) cases, caseous nodule in 4 (40%), perihepatic adhesions with a new sign Sharma's hanging gall bladder sign in which gall bladder hangs vertically or stands (instead of lying down position in normal cases) in abdominopelvic TB was observed on 4 (40%) cases. Conclusion: The new sign Sharma's Hanging Gall Bladder sign appears to be useful in early detection of abdomino-pelvic TB.