Role of laparoscopy in treatment of tubercular pyoperitoneum

Anubhav Goel; Ankur Bansal; Jinendra Rana; Chandrodaya Kumar

doi:10.18203/2349-2902.isj20182230

Authors

Anubhav Goel Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
Ankur Bansal Department of Surgery, S. R. Hospital, Agra, Uttar Pradesh, India
Jinendra Rana Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
Chandrodaya Kumar Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182230

Keywords:

Laparoscopy, Pyoperitoneum, Tubercular

Abstract

Background: Abdominal TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera, constitutes up to 12% of extrapulmonary TB and 1-3% of the total. Tuberculosis can involve any part of the gastrointestinal tract and is the sixth most frequent site of extrapulmonary involvement. Both the incidence and severity of abdominal tuberculosis are expected to increase with increasing incidence of HIV infection. Peritoneal tuberculosis occurs in three forms: wet type with ascitis, dry type with adhesions, and fibrotic type with omental thickening and loculated ascites. Aim of the present study was to evaluate the role of laparoscopy in cases of pyoperitoneum.

Methods: In present study authors included the cases of pyoperitoneum which is diagnosed by ultrasound aspiration and no sign of perforation of bowel and is hemodynamic stable.

Results: A total of 14 cases of pyoperitoneum were included. All underwent diagnostic laparoscopy. 3 had underlying ruptured appendicitis and excluded from study. Rest 11 had no perforation associated with it. 7 were female and 4 were male. Through lavarge of peritoneum done and drain placed in pelvis. Fluid was sent for ADA estimation which was increased in all eleven cases. DOTS treatment was started in all cases and they respond well to treatment in 6 month follow up.

Conclusions: Tubercular pyoperitoneum is common entity in surgical setting. Laparoscopy has got encouraging role in these cases as it avoids laparotomy and complications associated with it.

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References

Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. JAMA. 1999;282:677-86.

Suri S, Gupta S, Suri R. Computed tomography in abdominal tuberculosis. B J Radiol. 1999;72:92-8.

Jadvar H, Mindelzun RE, Olcott EW, Levitt DB. Still the great mimicker: Abdominal tuberculosis. AJR Am J Roentgenol. 1997;168:1455-60.

Gondal KM, Khan AFA. Changing pattern of Abdominal Tuberculosis. Pak J Surg. 1995;11:109-13

Batra A, Gulati MS, Sarma D, Paul SB. Sonographic appearances in abdominal tuberculosis. J of Clin Ultrasound. 2000;28:233-45.

Hulnick DH, Megibow AJ, Naidich DP, Hilton S, Cho KC, Balthazar EJ. Abdominal tuberculosis: CT evaluation. Radiology. 1985;157:199-204.

Hanson RD, Hunter TB. Tuberculous peritonitis: CT appearance. AJR Am J Roentgenol. 1985;144:931-2.

Dahlene DH, Jr, Stanley RJ, Koehler RE, Shin MS, Tishler JM. Abdominal tuberculosis: CT findings. J Comput Assist Tomogr. 1984;8:443-5.

Lee DH, Lim JH, Ko YT, Yoon Y. Sonographic findings of tuberculous peritonitis of wet ascitic type. Clin Radiol. 1991;44:306-10.

Al-Hilaly MA, Abu-Zidan FM, Zayed FF, Suleiman JD, Farid LS. Tuberculous appendicitis with perforation. Br J Clin Pract. 1990;44:632-3.

Dolin PJ, Raviglione MC, Kochi A. Global tuberculosis incidence and mortality during 1990–2000. Bull World Health Organ. 1994;72:213-20.

Dineeen P, Homan WP, Grafe WR. Tuberculous peritonitis: 43 years' expereince in diagnosis and treatment. Annal Surg. 1976;184(6):717-22.

Sanai FM, Bzeizi KI. Systematic review: tuberculous peritonitis–presenting features, diagnostic strategies and treatment. Alimentary Pharmacol Therapeut. Oct 2005;22(8):685-700.

Sinan T, Sheikh M, Ramadan S, Sahwney S, Behbehani A. CT features in abdominal tuberculosis: 20 years experience. BMC Med Imaging. 2002;2:3.

Epstein BM, Mann JH. CT of abdominal tuberculosis. AJR. 1982;139(5):861-6.

Jain R, Sawhney S, Bhargava DK, Berry M. Diagnosis of abdominal tuberculosis: sonographic findings in patients with early disease. AJR. 1995;165(6):1391-5.

Demirkazik FB, Akhan O, Ozmen MN, Akata D. US and CT findings in the diagnosis of tuberculous peritonitis. Acta Radiol. 1996;37(4):517-20.

Dwivedi M, Misra SP, Misra V, Kumar R. Value of ADA estimation in the diagnosis of tubercular ascites. Am J Gastroenterol. 1990;85:1123-5.

Sharma MP, Bhatia V. Abdominal tuberculosis. Ind J Med Res. 2004;120(4):305.