Apaydin B, Paksoy M, Bilir M, Zengin K, Saribeyoglu K, Taskin M
Department of Surgery, Cerrahpasa Medical Faculty of Istanbul University, Turkey.
Eur J Surg. 1999 Feb;165(2):158-63. doi: 10.1080/110241599750007360.
To assess the safety and efficacy of diagnostic laparoscopy in patients with tuberculous peritonitis.
Retrospective clinical study.
University hospital, Turkey.
8 patients (2 women, 6 men; mean age 26 years) who presented with tuberculous peritonitis between January 1994 and January 1996.
Laparoscopy under local anaesthesia with sedation (the 4 who presented with ascites) and laparotomy (the 4 who presented with an acute abdomen).
Clinical and laboratory findings, biochemical and microbiological analysis of ascites, histopathological examination of specimens, morbidity, and mortality.
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 inflamed haemorrhagic areas on the peritoneum could all be seen at laparoscopy. One of the 8 patients who underwent laparotomy developed a spontaneous enterocutaneous fistula during the early postoperative period. Two of eight patients died, one of an early enterocutaneous fistula and the other of cor pulmonale 3 1/2 months later. The remaining 6 patients survived without complications after antituberculous medical treatment.
Laparoscopy is a safe and accurate method of diagnosis of tuberculous peritonitis.
评估诊断性腹腔镜检查对结核性腹膜炎患者的安全性和有效性。
回顾性临床研究。
土耳其大学医院。
1994年1月至1996年1月期间出现结核性腹膜炎的8例患者（2例女性，6例男性；平均年龄26岁）。
局部麻醉加镇静下的腹腔镜检查（4例有腹水的患者）和剖腹手术（4例有急腹症的患者）。
临床和实验室检查结果、腹水的生化和微生物分析、标本的组织病理学检查、发病率和死亡率。
4例患者有腹水，4例有粘连。腹腔镜检查可见腹水；肝与膈、肝与肠、肠与腹壁之间的粘连；腹膜表面的粟粒结节；以及腹膜上的炎性出血区。8例行剖腹手术的患者中有1例在术后早期发生自发性肠皮肤瘘。8例患者中有2例死亡，1例死于早期肠皮肤瘘，另1例在3个半月后死于肺心病。其余6例患者在抗结核药物治疗后存活且无并发症。
腹腔镜检查是诊断结核性腹膜炎的一种安全、准确的方法。
