Diagnostic Laparoscopy in Suspected Abdominal Tuberculosis: A Tool for Diagnosis

Background: Abdominal tuberculosis has plagued mankind over decades and is a major reason of morbidity andmortality even today in the developing world. Establishing a histological diagnosis in abdominal tuberculosis can be difficult, frequently delaying treatment. This study was performed with a view to evaluate the role of laparoscopy for ascertaining the diagnosis in suspected abdominal tuberculosis. Methods: A retrospective clinical study, wherein the records of 33 patients who underwent diagnostic laparoscopy for suspected abdominal tuberculosis over a 1-year period were analyzed to establish its usefulness as a clue to histological diagnosis Results: From January 2019 to December 2019, 50 patients underwent diagnostic laparoscopies in our institution, of which 33 patients had unknown etiologies for pain abdomen and ascites. This subset of patients had been investigated for suspected abdominal tuberculosis with biochemical tests of serumand ascetic fluid, ultrasound and computed tomography before being considered for diagnostic laparoscopy. None had manifestations of extra-abdominal tuberculosis. At laparoscopy, 25 of these patients (78 %) had peritoneal nodules. Histological examination performed in 29 (87 %) patients was suggestive of TB by presence of caseating granuloma. Only 2 (6 %) patients had no findings on laparoscopy, however on continued follow up, no diagnosis were made for these patients. Conclusion: Diagnostic laparoscopy is apotential answer for the diagnostic dilemma posed by abdominal tuberculosis. In patients suspected to have abdominal tuberculosis without evidence of extra-abdominal disease, laparoscopy may be useful to establish a histological diagnosis.