title: Contribution of laparoscopy in the abdominal tuberculosis diagnosis: retrospective study of about 11 cases.
abstract: OBJECTIVE
  Abdominal tuberculosis is one of the most frequent extra-pulmonary localizations. Its diagnosis is difficult and may lead to a delayed prescription of specific treatment. This study is aimed at stressing the role of laparoscopy associated with a biopsy in the diagnostic confirmation of abdominal tuberculosis particularly in doubtful cases.
  
  
  METHODS
  The diagnostic features of 11 cases hospitalized for abdominal tuberculosis in the Paediatric Surgery Department of Fattouma Bourguiba Hospital in Monastir for a 6-year period (2001-2006), were evaluated retrospectively. The diagnosis of abdominal tuberculosis was substantiated histopathologically by laparoscopy in all cases. The epidemiological and clinical characteristics along with the laboratory, radiological and histological data were studied.
  
  
  RESULTS
  Eleven cases of abdominal tuberculosis with a mean age of 5.6 years were diagnosed. It was peritoneal tuberculosis in all cases and associated with intestinal localization in one case. A conversion to laparotomy was practiced in three patients: appendicular plastron in one case, pseudo-tumor aspect of an intestinal loop in another case and because of their pathological aspect appendicectomy and caecum biopsy in the third. The diagnosis was confirmed histologically by biopsies in nine cases and on excision pieces in the other two cases. All patients had an uneventful course with an antituberculosis treatment.
  
  
  CONCLUSIONS
  Abdominal tuberculosis is still frequent in Tunisia. Because of its non-specific clinical presentation and the limited means of investigation, a laparoscopy with biopsy should be practiced as first line diagnostic tool in case of doubtful abdominal tuberculosis. The earlier the diagnosis is established and an adapted antituberculosis treatment is started, the better the prognosis is.
authors.affiliation: Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia. jamila.chahed@rns.tn
authors.forename: Jamila
authors.initials: J
authors.lastname: Chahed
authors.forename: Mongi
authors.initials: M
authors.lastname: Mekki
authors.forename: Asma
authors.initials: A
authors.lastname: Mansour
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Brahim
authors.forename: Kais
authors.initials: K
authors.lastname: Maazoun
authors.forename: Saida
authors.initials: S
authors.lastname: Hidouri
authors.forename: Imed
authors.initials: I
authors.lastname: Krichene
authors.forename: Lassâad
authors.initials: L
authors.lastname: Sahnoun
authors.forename: Riyadh
authors.initials: R
authors.lastname: Jouini
authors.forename: Mohsen
authors.initials: M
authors.lastname: Belgith
authors.forename: Abdelfattah
authors.initials: A
authors.lastname: Zakhama
authors.forename: Mohamed Tahar
authors.initials: MT
authors.lastname: Sfar
authors.forename: Mohamed Neji
authors.initials: MN
authors.lastname: Gueddiche
authors.forename: Abdelaziz
authors.initials: A
authors.lastname: Harbi
authors.forename: Fethi
authors.initials: F
authors.lastname: Amri
authors.forename: Abdelmajid
authors.initials: A
authors.lastname: Mahfoudh
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Nouri
mesh_terms: D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D014395:Peritonitis, Tuberculous / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies; D014385:Tuberculosis, Gastrointestinal / Q000188:drug therapy / Q000473:pathology*; D014416:Tunisia