Role of laparoscopic surgery in the etiologic diagnosis of exsudative ascites: a prospective study of 90 cases

Bedioui, H.; Ksantini, Rachid; Nouira, Kais; Mekni, Amina; Daghfous, A.; Chebbi, Faouzi; Rebai, Wael; Ftériche, F.S.; Jouini, Mohamed; Kacem, Montasser; Mami, N. Ben; Filali, Azza; Bensafta, Zoubeir

doi:10.1016/s0399-8320(07)78354-9

Cited by 23 publications

(23 citation statements)

References 11 publications

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“…In a study from Tunisia investigating the etiology of exudative ascites, tuberculous peritonitis was detected in 51 of 90 patients (46). In another study, 152 of 305 patients with exudative ascites were diagnosed with tuberculous peritonitis (47).…”

Section: Discussionmentioning

confidence: 99%

Pooled analysis of 163 published tuberculous peritonitis cases from Turkey

2018

Turk J Med Sci

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Section: Discussionmentioning

confidence: 99%

Pooled analysis of 163 published tuberculous peritonitis cases from Turkey

2018

Turk J Med Sci

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“…Besides specific appearance, these procedures allow us to take a peritoneal biopsy, which is the gold standard for diagnosis [22] . In our series, 6 patients had undergone laparoscopy and one had a laparotomy and whitish tubercles on peritoneum were seen in all and adhesions in two.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous peritonitis in children: Report of nine patients and review of the literature

Dinler¹,

Şensoy²,

Helek³

et al. 2008

WJG

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AIM:To present our experience with tuberculous peritonitis treated in our hospital from [2002][2003][2004][2005][2006][2007]. METHODS: We reviewed the medical records of 9 children with tuberculous peritonitis. RESULTS: Nine patients (5 boys, 4 girls) of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications. CONCLUSION: Tu b e rc u l o u s p e r i t o n i t i s h a s t o be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.

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“…In the peritoneal carcinomatosis, peritoneal implants are generally larger upto 1 cm and distributed irregularly on the peritoneum, abdominopelvic viscera and diaphragm. 2 In a series of Barnard et al involving 90 patients the positive predictive value of the laparoscopy in peritoneal tuberculosis was 85%. Peritoneal biopsy confirmed the diagnosis of tuberculosis and peritoneal carcinomatosis in 98% and 100% of the cases respectively.The sensitivity and specificity of visual diagnostic laparoscopic in 176 patients with ascites of undetermined origin,the sensitivity and specificity of diagnostic visual laparoscopic peritoneal tuberculosis were 86% and 100% respectively.…”

Section: Discussionmentioning

confidence: 95%

“…Ascites of unknown origin are dominated by tuberculosis and 1,2 peritoneal carcinomatosis requiring early diagnosis and care . The means of imaging (ultrasound, CT scan, MRI) have 6 limitations in the etiological diagnosis of these patients .…”

Section: Discussionmentioning

confidence: 99%

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Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

Sharma

Thapa

Gupta

2017

J. Nepalgunj Med. College

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Introduction:Ascites is a consequence of many different etiologies, such as liver cirrhosis, neoplasm, tuberculous peritonitis, pyogenic peritonitis, congestive heart failure, renal and pancreatic diseases but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to identify the role of laparoscopy in the etiological diagnosis of ascites of unknown origin. Methods: This was a prospective study of the patients who underwent diagnostic laparoscopy to determine the causes of ascites of unknown origin in the Department of Surgery, Nepalgunj Medical College Teaching Hospital from April 2012 to May 2014. All the patients underwent laparoscopy for the evaluation of ascites after appropriate clinical and laboratory examinations, which failed to reveal the cause. Results: Peritoneal tuberculosis and carcinomatosis peritonei were the two most common causes found in 37.14% and 57.14% of cases respectively. The average age of the patients was 52 years. Distension of abdomen, abdominal pain and weight loss were the most frequently observed symptoms in 33 patients (100%), 26 patients (74.28%) and 18 patients (51.42%) respectively. The CT scan findings, were a omental thickening in 28 cases (80%), peritoneal nodules in 7(20%) patients and the intraabdominal lymph nodes in 13 patients (39.39%). Ovarian mass was found in 4 patients (11.42%). The histological diagnosis was a peritoneal carcinomatosis in 13 (37.14%) patients and peritoneal tuberculosis in 20 (57.1%) patients and in two patients nonspecific inflammation. The sensitivity and specificity of laparoscopic diagnosis in the diagnosis of peritoneal tuberculosis were 78.67% and 98.6% respectively and in the diagnosis of peritoneal carcinomatosis were 94.78% and 72.2% respectively. The positive predictive value was 97.3% and the negative predictive value was 73.7% for peritoneal tuberculosis and for peritoneal carcinomatosis the positive predictive value was 83.7% and negative predictive value was 94.87%. Conclusion: The etiologic diagnosis of ascites of unknown origin is difficult despite the availability of several tests. Laparoscopy with peritoneal biopsy has still got a role in diagnosing these types of ascites where the other laboratory and imaging studies fail to reveal the cause.

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Role of laparoscopic surgery in the etiologic diagnosis of exsudative ascites: a prospective study of 90 cases

Cited by 23 publications

References 11 publications

Pooled analysis of 163 published tuberculous peritonitis cases from Turkey

Pooled analysis of 163 published tuberculous peritonitis cases from Turkey

Tuberculous peritonitis in children: Report of nine patients and review of the literature

Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

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