The Role of Laparoscopy in Diagnosis of Ascites of Obscure Etiology

Background: The role of diagnostic laparoscopy was markedly decreased with the advent of major developments in noninvasive imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging. However, many reports suggest that imaging has a limited role in the diagnosis of exudative ascites. The aim of the present study was to answer the question if there still a place of laparoscopy in the diagnosis of ascites of obscure etiology?. Methods: We prospectively evaluated patients with undiagnosed exudative ascites seen in the internal medicine and general surgery departments in Sohag university hospital, Sohag, Egypt in the period from September 2014 till November 2016. Results: 32 patients were included in our study; 30 females(93.75%) and 2 males (6.25%) with a mean age of (range from 16 to 68 years. All patients were referred to surgery department due to ascites of obscure origin. No mortality was registered in this study; all patients were discharged from hospital the 2nd day after laparoscopy andreturned to their home activity. The final pathological diagnosis after examination of ascetic fluid and biopsies that weretaken by laparoscopy were carcinomatosis peritoneii in 24 (75%), tuberculous peritonitis in 6 (18.75%) and liver cirrhosis in 2 cases (6.25%). Conclusion: Despite great advances in noninvasive diagnostic imaging techniques; diagnostic laparoscopy is stilla valuable option for diagnosis of ascites of obscure etiology.