Department of Surgery, King Fahad Specialist Hospital, Dammam 31444, Eastern Province, Saudi Arabia.
Surg Endosc. 2010 Apr;24(4):908-10. doi: 10.1007/s00464-009-0692-z. Epub 2009 Sep 16.
Diagnostic laparoscopy currently is emerging as an important tool in the diagnostic armamentarium for abdominal tuberculosis (TB). However, the laparoscopic view may be deceiving even to the most experienced eyes, and it is not uncommon for TB to be diagnosed erroneously before the final histologic confirmation is received.
A retrospective review of 20 diagnostic laparoscopies was conducted. The cases erroneously diagnosed at laparoscopy were collected and analyzed.
Five cases (20%) were identified. For two patients, the laparoscopic findings were thought to be those of carcinomatosis, but histology showed TB. For the other three patients, TB was suspected laparoscopically, but the final diagnoses were carcinomatosis, spontaneous bacterial peritonitis, and panniculitis. Two patients died: one due to delayed diagnosis and treatment of abdominal TB and the other due to carcinomatosis.
For a percentage of patients, the laparoscopic features of abdominal TB at diagnostic laparoscopy may be mistaken for other pathologies. Caution should be exercised before disclosure of the provisional diagnosis to the patient based on laparoscopy alone without histologic confirmation.
诊断性腹腔镜检查目前作为腹部结核（TB）诊断工具正在兴起。然而，即使是最有经验的医生，腹腔镜下的表现也可能具有欺骗性，在收到最终的组织学确认之前，TB 被误诊并不罕见。
对 20 例诊断性腹腔镜检查进行回顾性分析。收集并分析了腹腔镜检查错误诊断的病例。
共发现 5 例（20%）。对于 2 名患者，腹腔镜检查结果被认为是癌转移的表现，但组织学检查显示为结核。对于其他 3 名患者，腹腔镜检查怀疑为 TB，但最终诊断为癌转移、自发性细菌性腹膜炎和脂膜炎。2 名患者死亡：1 例由于腹部 TB 的诊断和治疗延迟，另 1 例由于癌转移。
对于一部分患者，腹部 TB 的腹腔镜表现可能会被误诊为其他病理。在没有组织学确认的情况下，仅凭腹腔镜检查就向患者透露临时诊断之前，应谨慎行事。
