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The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology

Received: 26 December 2016     Accepted: 27 December 2016     Published: 6 February 2017
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Abstract

Background: The role of diagnostic laparoscopy was markedly decreased with the advent of major developments in noninvasive imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging. However, many reports suggest that imaging has a limited role in the diagnosis of exudative ascites. The aim of the present study was to answer the question if there still a place of laparoscopy in the diagnosis of ascites of obscure etiology?. Methods: We prospectively evaluated patients with undiagnosed exudative ascites seen in the internal medicine and general surgery departments in Sohag university hospital, Sohag, Egypt in the period from September 2014 till November 2016. Results: 32 patients were included in our study; 30 females(93.75%) and 2 males (6.25%) with a mean age of (range from 16 to 68 years. All patients were referred to surgery department due to ascites of obscure origin. No mortality was registered in this study; all patients were discharged from hospital the 2nd day after laparoscopy andreturned to their home activity. The final pathological diagnosis after examination of ascetic fluid and biopsies that weretaken by laparoscopy were carcinomatosis peritoneii in 24 (75%), tuberculous peritonitis in 6 (18.75%) and liver cirrhosis in 2 cases (6.25%). Conclusion: Despite great advances in noninvasive diagnostic imaging techniques; diagnostic laparoscopy is stilla valuable option for diagnosis of ascites of obscure etiology.

Published in Journal of Surgery (Volume 5, Issue 3-1)

This article belongs to the Special Issue Minimally Invasive and Minimally Access Surgery

DOI 10.11648/j.js.s.2017050301.13
Page(s) 12-15
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Ascites, Laparoscopy, Carcinomatosis Peritonei, Tuberculous Peritonitis, Liver Cirrhosis

References
[1] Bedoui, H., Ksantini, R., Nouira, K., et al. (2007) Role of Laparoscopic Surgery in the Etiologic Diagnosis of Exudative Ascites: A Prospective Study of 90 Cases. Gastroentérologie Clinique et Biologique, 31, 1146-1149.
[2] Henning, H. (1992) Indications and Contraindications of Diagnostic laparoscopy. Endoscopy, 24, 674-675.
[3] Parsons, S. L., Lang, M. W. And Steele, R. J. C. (1996) Malignant Ascites: A 2-Year Review from a Teaching Hospital. European Journal of Surgical Oncology, 22, 237-239.
[4] Luck, N. H., Khan, A. A., Alam, A., Butt, A. K. And Shafquat, F. (2007) Role of Laparoscopy in the Diagnosis of Low Serum Ascites Albumin Gradient. Journal of Pakistan Medical Association, 57, 33-34.
[5] Nebhani M, Boumzgou K, Brams S, Laghzaoui M, El Ahar H, Binhya S. (2004) Tuberculose pelvienne simulant une tumeur ovarienne bilatérale. J Gynecol Obstet Biol Reprod; 33: 145-7.
[6] Redah, D., Amedegnato, D., Napo-Koura, G, et al. (1993) La tuberculose péritonéale au CHU de Lombé-Tokion à propos de 108 cas. Médecine & Chirurgie Digestives, 22, 105-106.
[7] Han, C. M., Lee, C. L., Huang, K. G., et al. (2008) Diagnostic Laparoscopy in Ascites of Unknown Origin: Chang Gung Memorial Hospital 20 Year Experience. Chang Gung Medical Journal, 31, 378-383.
[8] Sanai FM, Bzeizi KI. (2005) Systematic review: tuberculous peritonitis — presenting features diagnostic strategies and treatment. Aliment Pharmacol Ther ; 22: 685-700.
[9] Shakil AO, Korula J, Kanel GC, Murrayn G, Reynolds TB. (1996) Diagnostic features of tuberculous peritonitis in the absence and presence of chronic liver disease: a case control study. Am J Med; 100: 179-85.
[10] Needleman L, Kurtz AB, Rifkin MD. et al. (1986). Sonography of benign diffuse liver diseas; accuracy pattern recognition and grading. AJR Am j Roentgnol.146; 1011-5.
[11] Jalan RJ, Hayes PC(1995). Laparocopy in the diagnosis of chronic liver diseases. Br J Hosp Med; 53; 81-6.
[12] Thoreau N, Fain O, Babinet P, Lortholary O, Robineau M, Valeyre D, et al. (2002) Tuberculose péritonéale: 27 cas dans la banlieue nord-est de Paris. Int J Tuberc Lung Dis; 6: 253-8.
[13] Demir K, Okten A, Kaymakoglu S, Dincer D, Besisik F, Cevikbas U, et al. (2001). Tuberculous peritonitis- report of 26 cases detailing diagnostic and therapeutic problems. Eur J Gastroenterol Hepatol; 13: 581-5.
[14] Menzies RI, Fitzgerald JM, Mulpeter K(1985). Laparoscopic diagnosis of ascites in Lesotho. Br Med J (Clin Res Ed); 291: 473-5.
[15] Moore SC, Ott BJ, Burton DD, RakelaJ (1984). Role of peritoneoscopy in the evaluation of ascites of unknown origin. GastrointestEndosc; 30: 148.
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    Wael Barakaat Ahmed Mohamed, Ahmed Eisa Ahmed, Usama Ahmed Arafa. (2017). The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology. Journal of Surgery, 5(3-1), 12-15. https://doi.org/10.11648/j.js.s.2017050301.13

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    ACS Style

    Wael Barakaat Ahmed Mohamed; Ahmed Eisa Ahmed; Usama Ahmed Arafa. The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology. J. Surg. 2017, 5(3-1), 12-15. doi: 10.11648/j.js.s.2017050301.13

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    AMA Style

    Wael Barakaat Ahmed Mohamed, Ahmed Eisa Ahmed, Usama Ahmed Arafa. The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology. J Surg. 2017;5(3-1):12-15. doi: 10.11648/j.js.s.2017050301.13

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  • @article{10.11648/j.js.s.2017050301.13,
      author = {Wael Barakaat Ahmed Mohamed and Ahmed Eisa Ahmed and Usama Ahmed Arafa},
      title = {The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology},
      journal = {Journal of Surgery},
      volume = {5},
      number = {3-1},
      pages = {12-15},
      doi = {10.11648/j.js.s.2017050301.13},
      url = {https://doi.org/10.11648/j.js.s.2017050301.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2017050301.13},
      abstract = {Background: The role of diagnostic laparoscopy was markedly decreased with the advent of major developments in noninvasive imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging. However, many reports suggest that imaging has a limited role in the diagnosis of exudative ascites. The aim of the present study was to answer the question if there still a place of laparoscopy in the diagnosis of ascites of obscure etiology?. Methods: We prospectively evaluated patients with undiagnosed exudative ascites seen in the internal medicine and general surgery departments in Sohag university hospital, Sohag, Egypt in the period from September 2014 till November 2016. Results: 32 patients were included in our study; 30 females(93.75%) and 2 males (6.25%) with a mean age of (range from 16 to 68 years. All patients were referred to surgery department due to ascites of obscure origin. No mortality was registered in this study; all patients were discharged from hospital the 2nd day after laparoscopy andreturned to their home activity. The final pathological diagnosis after examination of ascetic fluid and biopsies that weretaken by laparoscopy were carcinomatosis peritoneii in 24 (75%), tuberculous peritonitis in 6 (18.75%) and liver cirrhosis in 2 cases (6.25%). Conclusion: Despite great advances in noninvasive diagnostic imaging techniques; diagnostic laparoscopy is stilla valuable option for diagnosis of ascites of obscure etiology.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology
    AU  - Wael Barakaat Ahmed Mohamed
    AU  - Ahmed Eisa Ahmed
    AU  - Usama Ahmed Arafa
    Y1  - 2017/02/06
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    N1  - https://doi.org/10.11648/j.js.s.2017050301.13
    DO  - 10.11648/j.js.s.2017050301.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 12
    EP  - 15
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.s.2017050301.13
    AB  - Background: The role of diagnostic laparoscopy was markedly decreased with the advent of major developments in noninvasive imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging. However, many reports suggest that imaging has a limited role in the diagnosis of exudative ascites. The aim of the present study was to answer the question if there still a place of laparoscopy in the diagnosis of ascites of obscure etiology?. Methods: We prospectively evaluated patients with undiagnosed exudative ascites seen in the internal medicine and general surgery departments in Sohag university hospital, Sohag, Egypt in the period from September 2014 till November 2016. Results: 32 patients were included in our study; 30 females(93.75%) and 2 males (6.25%) with a mean age of (range from 16 to 68 years. All patients were referred to surgery department due to ascites of obscure origin. No mortality was registered in this study; all patients were discharged from hospital the 2nd day after laparoscopy andreturned to their home activity. The final pathological diagnosis after examination of ascetic fluid and biopsies that weretaken by laparoscopy were carcinomatosis peritoneii in 24 (75%), tuberculous peritonitis in 6 (18.75%) and liver cirrhosis in 2 cases (6.25%). Conclusion: Despite great advances in noninvasive diagnostic imaging techniques; diagnostic laparoscopy is stilla valuable option for diagnosis of ascites of obscure etiology.
    VL  - 5
    IS  - 3-1
    ER  - 

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Author Information
  • Department of Surgery, Sohag University, Sohag, Egypt

  • Department of Surgery, Sohag University, Sohag, Egypt

  • Department of Internal Medicine, Sohag University, Sohag, Egypt

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