Role of Laparoscopy in the Diagnosis of Tuberculous Peritonitis in Children

Abstract

Tuberculous peritonitis (TP) is a rare disease in children, and this diagnosis is difficult. Clinical signs and routine hematologic investigations are nonspecific, and a tuberculin skin test can be negative. Bacteriologic investigations on samples of ascitic fluid, like retrieval of acid-fast bacilli and mycobacterial cultures, are often negative. We report a case of TP in a child in which all investigations were negative. Laparoscopy was performed, which showed the specific lesions of TP, with multiple intestinal adhesions and dissemination of whitish micronodules on the peritoneum. This laparoscopic approach allowed us to perform biopsies, which confirmed the diagnosis on histopathology examination and cultures. Laparoscopy is a safe and feasible approach when one suspects TP in children, leading to confirmation of the diagnosis on peritoneal biopsies with low morbidity.