Contribution of laparoscopy in the abdominal tuberculosis diagnosis: retrospective study of about 11 cases.
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.
Chahed
Jamila
J
Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia. jamila.chahed@rns.tn
Mekki
Mongi
M
Mansour
Asma
A
Ben Brahim
Mohamed
M
Maazoun
Kais
K
Hidouri
Saida
S
Krichene
Imed
I
Sahnoun
Lassâad
L
Jouini
Riyadh
R
Belgith
Mohsen
M
Zakhama
Abdelfattah
A
Sfar
Mohamed Tahar
MT
Gueddiche
Mohamed Neji
MN
Harbi
Abdelaziz
A
Amri
Fethi
F
Mahfoudh
Abdelmajid
A
Nouri
Abdellatif
A
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