LAPAROSCOPIC OBSERVATIONS OF A PATIENT WITH TUBERCULOUS PERITONITIS

Abstract

A case of 21 year-old female with tuberculous peritonitis was reported. She received lapar.oscopy 3 times at the following 3 stages ; zenith, after 3 months of the first laparoscopy and the healing stage. At the first laparoscopy, multiple miliary to rice sized yellow-whitish nodules were seen on her parietal and visceral peritoneum, the sorosa of the gall bladder and the bowel, and hepatic capsule. Tuberculous granuloma was proven histologically by biopsy of these nodules. She had been placed on SM, RFP and INAH until discharge. At the second examination, the nodules previously seen were diminished or decreased remarkably. "Zuckerguss" liver was seen on the surface of the right hepatic lobe. At the third examination, the TB nodules were completly diminished. "Zuckerguss" liver and peritoneal adhesion were seen. The healing of the disease was proven laparosco pically at this time. Although the incidence of TB peritonitis is quite rare in these years, it is very significant to observe chronological changes laparoscopically from the zenith to healing stage, once this disease is diagnosed.