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New Indian Journal of Surgery

Volume  10, Issue 2, March-April 2019, Pages 193-199

 

Original Article

Abdominal Tuberculosis: Laparoscopy A Novel Tool for Diagnosis
Priti Shah1, Anuradha Dnyanmote2, Neha Srivastava3, Mridula Eswarawaka4, Pratham Mody5, Ashish Tyagi6
1,2Professor, 3,4,5,6Junior Resident, Department of General Surgery, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra 411018, India.
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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10219.11

Abstract

 Objective: To analyze the efficacy of diagnostic laparoscopy for diagnosing abdominal tuberculosis in susceptible cases. Methods: The records of 20 patients (15 males, 5 females, mean age 35, range 20-70 years) diagnosed with abdominal TB by diagnostic laparoscopy in Dr. D.Y. Patil hospital between june 2017-june 2018, were analyzed. Results: Chronic abdominal pain was the most common presenting complaint (85% of the patients) followed by history of weight loss and loss of appetite (65% patients). Other common findings were evening rise of fever (50%), altered bowel habits (30%), ascites (35%), abdominal distension (25%). Radiological findings were suggestive of lymphadenopathy (60%), circumferential wall thickening (25%) and (10%) stricutres or adhesions. Patients were posted for diagnostic laparoscopy after thorough investigations and high suspicions of abdominal tuberculosis. Biopsies were taken in all cases and 40% patients required adhesiolysis whereas 10% patients required stricturoplasty. All biopsied specimens were sent for HPE, culture and sensitivity, geneXpert and TBPCR and it helped in the confirmation of abdominal tuberculosis. Conclusion: Diagnostic laparoscopy as a tool for early diagnosis and hence early medical management of abdominal tuberculosis has been a recent and novel advancement in the field of surgery. It has also lead to the prevention of mortality and morbidity caused by abdominal tuberculosis by eliminating emergency exploratory laparotomies and delayed diagnosis.

Keywords: abdominal tuberculosis; diagnostic laparoscopy.


Corresponding Author : Neha Srivastava