Pediatric Surgery International

, Volume 26, Issue 4, pp 413–418 | Cite as

Contribution of laparoscopy in the abdominal tuberculosis diagnosis: retrospective study of about 11 cases

  • Jamila Chahed
  • Mongi Mekki
  • Asma Mansour
  • Mohamed Ben Brahim
  • Kais Maazoun
  • Saida Hidouri
  • Imed Krichene
  • Lassâad Sahnoun
  • Riyadh Jouini
  • Mohsen Belgith
  • Abdelfattah Zakhama
  • Mohamed Tahar Sfar
  • Mohamed Neji Gueddiche
  • Abdelaziz Harbi
  • Fethi Amri
  • Abdelmajid Mahfoudh
  • Abdellatif Nouri
Original Article

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.

Conclusion

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.

Keywords

Children Abdominal tuberculosis Laparoscopy 

Abbreviations

ESR

Erythrocyte sedimentation rate

CRP

C reactive protein

PCR

Polymerase chain reaction

CT

Computerized tomography

M

Male

F

Female

BK

Koch bacillus

TBC

Tuberculosis

HIV

Human immunodeficiency virus

ADA

Adenosine desaminase activity

Notes

Acknowledgments

Our thanks to Adel Rdissi (English teacher at the Medical School of Monastir) for proof reading this article.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Jamila Chahed
    • 1
  • Mongi Mekki
    • 1
  • Asma Mansour
    • 1
  • Mohamed Ben Brahim
    • 1
  • Kais Maazoun
    • 1
  • Saida Hidouri
    • 1
  • Imed Krichene
    • 1
  • Lassâad Sahnoun
    • 1
  • Riyadh Jouini
    • 1
  • Mohsen Belgith
    • 1
  • Abdelfattah Zakhama
    • 2
  • Mohamed Tahar Sfar
    • 3
  • Mohamed Neji Gueddiche
    • 4
  • Abdelaziz Harbi
    • 5
  • Fethi Amri
    • 6
  • Abdelmajid Mahfoudh
    • 7
  • Abdellatif Nouri
    • 1
  1. 1.Paediatric Surgery DepartmentFattouma Bourguiba HospitalMonastirTunisia
  2. 2.Anatomopathology DepartmentFattouma Bourguiba HospitalMonastirTunisia
  3. 3.Paediatric DepartmentT. Sfar HospitalMahdiaTunisia
  4. 4.Paediatric DepartmentFattouma Bourguiba HospitalMonastirTunisia
  5. 5.Paediatric DepartmentSahloul HospitalSousseTunisia
  6. 6.Paediatric DepartmentKairouan HospitalKairouanTunisia
  7. 7.Paediatric DepartmentHedi Chaker HospitalSfaxTunisia

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