title: Diagnostic yield and endoscopic patterns of laparoscopy in the diagnosis of granulomatous hepatitis.
abstract: In reviewing 54 cases of granulomatous hepatitis (GH) diagnosed among 2,620 laparoscopies, we have been able to classify the capsular GH changes into five patterns: Macular, exudative, pinpoint, granular and cord-like. The exudative pattern was the most frequent one, and predominated in brucellosis. The granular pattern was most common in tuberculosis. Furthermore, 35 additional cases, in whom a laparoscopic diagnosis of GH was not confirmed by liver biopsy, showed a trend to a final diagnosis consistent with multifocal diseases, whenever laparoscopic pictures were similar to the patterns described herein. We speculate with the limits associated with the use of only a single biopsy sample. We conclude that laparoscopy permits the establishment of a tentative diagnosis of GH, which could provide us with valuable information about the usefulness of obtaining multiple hepatic biopsies.
authors.affiliation: Gastroenterology Service, Hospital de Cruces, Faculty of Medicine, Bilbao, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Moretó
authors.forename: M
authors.initials: M
authors.lastname: Testillano
authors.forename: M
authors.initials: M
authors.lastname: Zaballa
authors.forename: M
authors.initials: M
authors.lastname: Suárez
authors.forename: S
authors.initials: S
authors.lastname: Ibáñez
mesh_terms: D004724:Endoscopy; D006505:Hepatitis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000473:pathology