TITLE:
Role of Coelioscopy in the Etiologic Diagnosis of Exudative Ascites of Unknown Origin of the Women
AUTHORS:
Mohamed Ben Mabrouk, Aida Ben Slama Trabelsi, Mohamed Ben Rejeb, Hanène Jaziri, Mehdi Ksiaa, Sassi Bouguizane, Badreddine Sriha, Ali Jmaa, Ali Ben Ali
KEYWORDS:
Ascites, Exudative, Laparoscopy, Peritoneal Tuberculosis, Peritoneal Carcinomatosis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.5,
May
27,
2015
ABSTRACT:
Introduction:
The aim of this study was to clarify the role of laparoscopy in the etiological
diagnosis of exudative ascites of unknown origin in women. Materials and
Methods: Thiswasa prospective study from 2007 to 2012,
including 83 women with exudative ascites of unknown origin and had a
laparoscopy diagnostic purpose. Results: Carcinomatosis and peritoneal
tuberculosis were the two most common causes found in 31% (26 cases) and 66%
(55 cases) of cases respectively. The average age of the patients was 56 years.
Weight loss and abdominal pain were the most frequent, observed symptoms in 71
cases (85.5%) and 53 cases (63.8%) respectively. The CT scan abnormalities
notedwere a peritoneal
thickening in 32 cases (38.5%), peritoneal nodules in 15 cases (18%), and
agglutination of the digestive handles in 12 cases (14.4%). Laparoscopic Visual
diagnosis was in favor of a peritoneal carcinomatosis in 32 cases (38.5%),
peritoneal tuberculosis in 45 cases (54.2%), and non specific infection in 6
cases (7.3%). The histological diagnosis was a peritoneal carcinomatosis in 26
cases (31%), and peritoneal tuberculosis in 55 cases (66%). The positive
predictive value of laparoscopic vision Diagnostics in Peritoneal tuberculosis
was 100% and the negative predictive value was 73.7%. In peritoneal carcinomatosis,
the positive predictive value was 81.3% and the negative predictive value was
100%. Conclusion: The etiologic diagnosis of exudative ascites in women is
difficult despite the availability of several tests. Currently, laparoscopy
with peritoneal biopsy remains the gold standard for etiologic diagnosis.