Laparoscopic evaluation of ascites and other abdominal conditions in Ethiopia

The purpose of this study is to evaluate the appropriateness of laparoscopic examination in Ethiopia where chronic liver diseases and tuberculous peritonitis commonly present with ascites. A total of 240 patients were examined consecutively. The indications were ascites (62%) hepatomegaly (29%), splenomegaly (22%), oesophageal varices (31%), abdominal masses (6%) and miscellaneous conditions (5%). Laparoscopic findings included cirrhosis with or without primary hepatocellular carcinoma (PHC) in 72% and tuberculous peritonitis in 6% of 232 successfully examined cases. Biopsies were possible in 165 cases. When all 144 patients with ascites were separately analyzed, 82% were due to cirrhosis of the liver with or without PHC and 9% tuberculous peritonitis. There was a good correlation between laparoscopic and histological diagnosis. Though invasive, the procedure carries low morbidity and the diagnostic yield is high. The laparoscope, therefore, should be considered as an appropriate technology for developing countries.