Objective: To assess the safety and efficacy of diagnostic laparoscopy in p
atients with tuberculous peritonitis.
Design: Retrospective clinical study.
Setting: University hospital, Turkey.
Subjects: 8 patients (2 women, 6 men; mean age 26 years) who presented with
tuberculous peritonitis between January 1994 and January 1996.
Intervention: Laparoscopy under local anaesthesia with sedation (the 4 who
presented with ascites) and laparotomy (the 4 who presented with an acute a
bdomen).
Main outcome measures: Clinical and laboratory findings, biochemical and mi
crobiological analysis of ascites, histopathological examination of specime
ns, morbidity, and mortality.
Results: 4 patients presented with ascites, and 4 with adhesions. Ascites;
adhesions between liver and diaphragm, liver and intestines, and intestines
and the abdominal wall; miliary nodes on the peritoneal surface; and infla
med haemorrhagic areas on the peritoneum could all be seen at laparoscopy.
One of the 8 patients who underwent laparotomy developed a spontaneous ente
rocutaneous fistula during the early postoperative period. Two of eight pat
ients died, one of an early enterocutaneous fistula and the other of cor pu
lmonale 3 1/2 months later. The remaining 6 patients survived without compl
ications after antituberculous medical treatment.
Conclusions: Laparoscopy is a safe and accurate method of diagnosis of tube
rculous peritonitis.