|
Eser Vardareli,
Baybora Kircali, Osmangazi University Medical Faculty Department
of Gastroenterology Meselik Eskisehir
Correspondence to: Baybora Kircali, Osmangazi University
Medical Faculty Department of Gastroenterology
Meselik Eskisehir. bkircali@yahoo.com
Received: 2004-12-21
Accepted: 2005-01-25
© 2005 The WJG Press and Elsevier Inc. All rights reserved.
Key words: Abdominal tuberculosis
Vardareli E, Kircali B. A diagnostic approach to abdominal
tuberculosis. World J Gastroenterol
2005; 11(21): 3328
http://www.wjgnet.com/1007-9327/11/3328.asp
TO THE EDITOR
We read with interest the article by Uzunkoy et al[1].
about diagnosis of abdominal tuberculosis. In this article authors
concluded that PCR for mycobacterium tuberculosis complex is a
noninvasive method which can provide the diagnosis in most cases. If
this tests negative or not feasible, laparotomy should be performed.
Previously, we analyzed and reported the
diagnostic approach to peritoneal tuberculosis of our clinic[2].
In this paper, diagnosis of the peritoneal tuberculosis was made by
image-guided percutanous biopsy (IGPB) in 18/19 of
patients. Laparoscopic biopsy was needed only 1/19 patient.
Laparoscopic biopsy allows better inspection as well as directed
biopsies from peritoneum. However, it requires hospitalization, and
has some complications. Therefore, IGPB seems to be an effective,
safe and inexpensive method to provide diagnosis of peritoneal
tuberculosis. In editorial of this article, Dhiman stated that IGPB
is less invasive as compared to laparoscopy, does not requires
general anesthesia and can be performed even at bedside. An
algorithmic approach was suggested by doing IGPB or image-guided
biopsy from associated lessions first, and if the results are
inconclusive then laparoscopic biopsy may be the next step[3].
In conclusion, mycobacterial culture requires 8
wk to make diagnosis this delay can give way to an increased
mortality rate. If PCR for mycobacterium tuberculosis is not
diagnostic or not feasible, IGPB should be performed.
REFERENCES
1
Uzunkoy A, Harma M, Harma M. Diagnosis of abdominal
tuberculosis: Experience from 11 cases and review of
the literature. World J
Gastroenterol 2004; 10: 3547-3647
2
Vardareli E, Kebapci M, Saricam T, Pasaoglu O,
Acikalin M. Tuberculous perof the wet ascitic type: clinical
features
and diagnostic value of image-guided
peritoneal biopsy. Dig Liver Dis 2004; 36: 199-204
3
Dhiman RK. Tuberculous peritonitis: towards a positive
diagnosis. Dig Liver Dis 2004; 36: 175-177
Science
Editor Guo SY Language
Editor Elsevier HK
| |
PubMed
