Peritoneoscopy and guided biopsy in the diagnosis of intraabdominal disease.

In 145 cases of intraabdominal disease, a laparotomy was considered the next diagnostic step, but peritoneoscopy was performed instead. In 37 cases with a suspicion of metatastic carcinoma, peritoneoscopy with guided biopsy demonstrated carcinoma in 29. In 32 cases, with biopsy-proven cirrhosis of the liver with high suspicion of a hepatoma, peritonescopy demonstrated the presence of hepatoma in 12. In 28 cases, protracted unexplained jaundice was present; nonsurgical causes for jaundice were found in 15. In 48 cases an exudative (protein greater than 2.5 per 100 ml) ascites was present. In 19 cases, either tuberculosis or carcinomatous implants of the peritoneum were found, and ovarian carcinoma was found in 9. Peritoneoscopy with guided biopsy obviated the need for laparotomy in 90% of these cases.