title: Abdominal tuberculosis: utility of laparoscopy in the correct diagnosis.
abstract: BACKGROUND
  Abdominal tuberculosis is one of the most prevalent form of extra-pulmonary disease, and the diagnosis is difficult because of non-specific clinical features.
  
  
  METHODS
  We presented a case of a Tunisian woman with cough, nausea, decreased appetite and pelvic-abdominal pain. CT scan showed peritoneal thickening, peritoneal tiny nodules and enlarged mesenteric lymph nodes ascitic fluid. Sputum analysis was negative. Abdominal paracentesis was performed, and no malignant cell was detected. The Ziehl staining revealed a negativity for acid-fast bacilli.
  
  
  RESULTS
  Diagnostic laparoscopy was performed. Biopsy specimens of peritoneum, liver, omentum and diaphragm showed omental epithelioid granulomas with a centrale caseous necrosis and Langhans giant cells. The patient received anti-tubercular treatment.
  
  
  CONCLUSIONS
  In case of suspicion of tuberculosis, when bacteriologic and cytologic analysis is negative, laparoscopy with biopsies is helpful for correct diagnosis and appropriate management.
authors: Department of General Surgery, Hospital Tenon, Paris, France, mirkomuron@yahoo.fr.
authors: Mirko
authors: M
authors: Muroni
authors: Audrey
authors: A
authors: Rouet
authors: Isabelle
authors: I
authors: Brocheriou
authors: Sidney
authors: S
authors: Houry
mesh_terms: D000005:Abdomen / Q000382:microbiology* / Q000473:pathology; D001201:Ascites / Q000209:etiology; D001706:Biopsy; D003964:Diaphragm / Q000473:pathology; D005260:Female; D015744:Giant Cells, Langhans / Q000473:pathology; D006099:Granuloma / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D009852:Omentum / Q000473:pathology; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy
references: World J Gastroenterol. 2006 Oct 21;12(39):6371-5
references: 17072964
references: World J Gastroenterol. 2003 May;9(5):1098-101
references: 12717865
references: World J Surg. 2011 Nov;35(11):2369-75
references: 21882025
references: Aliment Pharmacol Ther. 2005 Oct 15;22(8):685-700
references: 16197489
references: Am J Gastroenterol. 1992 Jan;87(1):109-12
references: 1530803
references: J R Soc Med. 2003 Dec;96(12):586-8
references: 14645607
references: Taiwan J Obstet Gynecol. 2011 Sep;50(3):292-6
references: 22030041
references: Eur Radiol. 2004 Mar;14 Suppl 3:E103-15
references: 14749955
references: J Am Assoc Gynecol Laparosc. 2004 May;11(2):269-72
references: 15200789