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



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.


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.


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.


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.


Children Abdominal tuberculosis Laparoscopy 



Erythrocyte sedimentation rate


C reactive protein


Polymerase chain reaction


Computerized tomography






Koch bacillus




Human immunodeficiency virus


Adenosine desaminase activity



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


  1. 1.
    Boukthir S, Mrad SM, Becher SB et al (2004) Abdominal tuberculosis in children. Report of 10 cases. Acta Gastroenterol Belg 67:245–249PubMedGoogle Scholar
  2. 2.
    Shakil AO, Korula J, Kanel JC et al (1996) Diagnostic features of tuberculous peritonitis in the absence and presence of chronic liver disease: a case control study. Am J Med 100:179–185CrossRefPubMedGoogle Scholar
  3. 3.
    Sharma SK, Kadhiraven T, Banga A et al (2004) Spectrum of clinical disease in a cohort of 135 hospitalised HIV infected patients from north India. B M C infect Dis 4:52CrossRefGoogle Scholar
  4. 4.
    Uygur-Bayramicli O, Dabak G, Dabak R (2003) Clinical dilemma: abdominal tuberculosis. World J Gastroenterol 9:1098–1101PubMedGoogle Scholar
  5. 5.
    Elabekri M, Benajah DA, Aqodad N et al (2006) Peritoneal tuberculosis in the Fes university hospital (Moroccco). Gastroenterol Clin Biol 30:377–381Google Scholar
  6. 6.
    Singhal A, Gulati A, Frizell R, Manning AP (2005) Abdominal tuberculosis in Bradford. Eur J Gastroenterol Hepatol 17:967–971CrossRefPubMedGoogle Scholar
  7. 7.
    Yilmaz T, Sever A, Gür S et al (2002) CT findings of abdominal tuberculosis in 12 patients. Comput Med Imaging Graph 26:321–325CrossRefPubMedGoogle Scholar
  8. 8.
    Akhan O, Pringot J (2002) Imaging of abdominal tuberculosis. Eur Radiol 12:312–323CrossRefPubMedGoogle Scholar
  9. 9.
    Dafiri R, Imani F (2001) Abdominal tuberculosis. Encyl. Méd. chir (Scientific and Medical editions. Elsevier SAS; Paris). Radiodiagnostic-appareil digestif; 33-010-A30; 12 pGoogle Scholar
  10. 10.
    Manohar A, Simjee AE, Haffejee AA, Pettengel KE (1990) Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period. Gut 31(10):1130–1132CrossRefPubMedGoogle Scholar
  11. 11.
    Marshall JB (1993) Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 88(7):989–999PubMedGoogle Scholar
  12. 12.
    Bennani A, Ouzzani H, Fadli F et al (1988) Diagnostic and therapeutic aspects of peritoneal tuberculosis in Morroco. About 300 cases. Ann Gastroenterol Hepatol (Paris) 24(7):347–354Google Scholar
  13. 13.
    Dautzenberg B (1993) Hepatogastroenteric aspects of tuberculosis in 1993. Gastroenterol Clin Biol 17(1):623–625PubMedGoogle Scholar
  14. 14.
    Collado C, Stirnemann J, Ganne N et al (2005) Gastrointestinal tuberculosis: 17 cases collected in 4 hospitals in the northeastern suburb of Paris. Gastroenterol Clin Biol 29(4):419–424PubMedCrossRefGoogle Scholar
  15. 15.
    Peghini M, Rajaonarison P, Pecarrere JL et al (1995) Peritoneal tuberculosis in Madagascar, 55 cases at the Saovindriana center in Antananarivo. Arch Inst Pasteur Madagascar 62(1):99–102PubMedGoogle Scholar
  16. 16.
    Sanai FM, Bzeizi KI (2005) Systematic review: tuberculous peritonitis-presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther 22:685–700CrossRefPubMedGoogle Scholar
  17. 17.
    Dhiman RK (2004) Tuberculous peritonitis: towards a positive diagnosis. Dig Liver Dis 36:175–177CrossRefPubMedGoogle Scholar
  18. 18.
    Sathar MA, Simjee AE, Coodavia YM et al (1995) Ascitic fluid gamma interferon concentrations and adenosine deaminase activity in tuberculous peritonitis. Gut 36(9):419–421CrossRefPubMedGoogle Scholar
  19. 19.
    Burgess LJ, Swanepoel CG, Taljaard JJ (2001) The use of adenosine deaminase as a diagnostic tool for peritoneal tuberculosis. Tuberculosis (Edinb) 81(3):243–248CrossRefGoogle Scholar
  20. 20.
    Volpi E, Calgaro M, Ferrero A et al (2004) Genital and peritoneal tuberculosis: potential role of laparoscopy in diagnosis and management. J Am Assoc Gynecol Laparosc 11(2):269–272CrossRefPubMedGoogle Scholar
  21. 21.
    Sharmer MP, Bhatia Vikram (2004) Abdominal tuberculosis. Review article. Indian J Med Res 120(4):305–315Google Scholar
  22. 22.
    Bhargava DK, Shriniwas, Chopra P et al (1992) Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol 87(1):109–112Google Scholar
  23. 23.
    Wilairatana P, Wilairatana S, Lekhyananda et al (1993) Does laparoscopy have a limited role in the diagnosis of fibroadhesive tuberculous peritonitis? Southeast Asian J Trop Med public health 24(4):762–765Google Scholar
  24. 24.
    Ibrarullah M, Mohan A, Sarkari A et al (2002) Abdominal tuberculosis: diagnosis by laparoscopy and colonoscopy. Trop Gastroenterol 23(3):150–153PubMedGoogle Scholar
  25. 25.
    Yilmaz Akgun MD (2005) Intestinal and peritoneal tuberculosis: changing trends over 10 years and a review of 80 patients. Can J Surg 48(2):131–136PubMedGoogle Scholar
  26. 26.
    Kapoor VK (2007) Abdominal tuberculosis. Medicine. Gastroenterology Part 3 of 4. 35:(5)257–260Google Scholar

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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