Diagnostic Laparoscopy for Abdominal Tuberculosis: A Promising Tool for Diagnosis

Abstract

Introduction: Abdominal tuberculosis has plagued the mankind over several decades and is a major reason of morbidity and mortality even today in the developing world. It's a difficult problem to diagnose as most patients present with vague and nonspecific symptomatology. This study was performed with a view to find out an efficient and practical tool for diagnosing this problem. Methods: This analytical descriptive study including 283 patients of abdominal tuberculosis is a continuation of an earlier study by the author in the same context. The study was conducted to highlight the usefulness of diagnostic laparoscopy in patients with vague abdominal symptoms, posing difficulty in establishing a conclusive diagnosis. The study extended over a nine-year period in a teaching hospital as well as some private hospitals. The data was collected and statistically analyzed on SPSS version 22. Results: We had a total of 266 patients with unsettled diagnosis having vague abdominal symptoms. Out of the total study subjects, 214 (80.45%) were finally conclusively diagnosed to have abdominal tuberculosis on diagnostic laparoscopy. Abdominal pain is the most frequent symptom which makes the patients seek medical advice coupled with changing bowel habits, loss of weight and generalized weakness. Laparoscopy revealed various tuberculous lesions which were biopsied and diagnosed. Conclusion: Diagnostic laparoscopy is a potential answer for the diagnostic dilemma posed by abdominal tuberculosis. Its efficacy and reliability need further studies in future.

Gastrointestinal tuberculosis presenting as a diagnostic dilemma with unusual sequalae of Posterior Reversible Encephalopathy Syndrome

“…Colonoscopic biopsy is useful, however specimens may only demonstrate active chronic ileocolitis with ulceration and granuloma formation whilst AFB stains are only positive in 25–30% of cases. Laparoscopy with fresh biopsy specimens for PCR is emerging as the gold standard with a diagnostic yield of over 80% 6,7 …”

“…Laparoscopy with fresh biopsy specimens for PCR is emerging as the gold standard with a diagnostic yield of over 80%. 6,7 Most patients with abdominal tuberculosis respond to the same medical treatment used for pulmonary tuberculosis. This comprises rifampicin and isoniazid for 6 months and pyrazinamide and ethambutol for 2 months.…”