Role of Coelioscopy in the Etiologic Diagnosis of Exudative Ascites of Unknown Origin of the Women

Mohamed Ben Mabrouk^1*, Aida Ben Slama Trabelsi², Mohamed Ben Rejeb³, Hanène Jaziri², Mehdi Ksiaa², Sassi Bouguizane⁴, Badreddine Sriha⁵, Ali Jmaa², Ali Ben Ali¹

¹Department of Digestive Surgery, Sahloul Hospital, Sousse, Tunisia.
²Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia.
³Department of Preventive Medicine, Sahloul Hospital, Sousse, Tunisia.
⁴Department of Gynecology, Farhat Hached Hospital, Sousse, Tunisia.
⁵Department of Pathology, Farhat Hached Hospital, Sousse, Tunisia.

DOI: 10.4236/jct.2015.65050                

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: This was a 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 noted were 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.

Keywords

Ascites, Exudative, Laparoscopy, Peritoneal Tuberculosis, Peritoneal Carcinomatosis

Conflicts of Interest

The authors declare no conflicts of interest.

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