Peritoneoscopy: experience in Sudan.

ABSTRACT

INTRODUCTION: The use of peritoneoscopy is an established method for diagnosis of intra abdominal diseases. In industrialized countries such as USA and Germany its use has declined with the advent of modern imaging techniques. However it is believed that there is an important rationale for its use in developing countries. STUDY AIMS: A retrospective study to assess the value of peritoneoscopy in a developing country (Sudan). PATIENTS AND METHODS: A total of 274 patients were included in this study. Peritoneoscopy was performed in the endoscopy theatre, using standard techniques. Biopsy specimens were taken, when required, from relevant tissues. The patients were closely monitored during and following the procedure. RESULTS: Peritoneoscopy was indicated for assessment of hepatomegaly in 108 (39.1%) patients, exudative ascites 66 (24%), diagnosis of abdominal mass 48 (17.5%) and miscellaneous indications 52 (19.4%). The final diagnosis of all cases after peritoneoscopy included malignancies other than hepatocellular carcinoma (HCC) 81 (29.8%) patients, miscellaneous conditions 60 (21.8%), HCC 45 (16.4%), liver cirrhosis 26 (9.4%), abdominal tuberculosis 24 (9.4%), normal liver 16 (5.8%), hepatosplenic schistosomiasis (HSS) 15 (5.5%) and amoebic liver abscess 7 (2.5%). The peritoneoscopic appearance of HSS was very characteristic. CONCLUSION: This large study confirms that peritoneoscopy has a high diagnostic yield and is a cost-effective technique for use in developing countries.