JB Sharma's white cotton ball sign: A new laparoscopic sign in abdominopelvic tuberculosis

Background: Abdominopelvic tuberculosis (TB) is a variant of extrapulmonary TB causing significant morbidity, including infertility. Materials and Methods: Results of 87 cases of diagnostic laparoscopy in cases of abdominopelvic TB diagnosed on composite reference standard (CRS) for demonstration of...

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Bibliographic Details
Main Author: Jai Bhagwan Sharma
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-01-01
Series:Journal of Minimal Access Surgery
Subjects:
Online Access:http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=24;epage=29;aulast=Sharma
Description
Summary:Background: Abdominopelvic tuberculosis (TB) is a variant of extrapulmonary TB causing significant morbidity, including infertility. Materials and Methods: Results of 87 cases of diagnostic laparoscopy in cases of abdominopelvic TB diagnosed on composite reference standard (CRS) for demonstration of new laparoscopic white cotton ball sign are presented. Results: Mean age, parity and duration of infertility were 27.2 years, 0.21 and 3.1 years, respectively. Oligomenorrhoea and hypomenorrhea were seen in 35 (40.22%) and 32 (36.78%) cases, while infertility was seen in all 87 (100%) cases while abdominal mass was seen in 27 (31.03%) cases and pelvic mass in 37 (42.58%) cases. Positive acid fast bacilli on microscopy and culture of endometrial biopsy was seen in 3.34% and 6.89% cases while epithelioid granuloma was seen in 12.64% cases on endometrial biopsy and in 13.79% cases on peritoneal biopsy. Positive polymerase chain reaction was seen in all cases while definitive abdominal pelvic TB was seen in 35 (40.1%) cases and probable findings in 42 (48.27%) cases. A new laparoscopic white cotton ball sign (resembling a large white cotton ball) was observed in 5 (5.74%) cases and biopsy from 3 showed it to be epithelioid granulomas positive. Conclusion: Demonstration of a new white cotton ball sign on laparoscopy seems to be a useful finding in abdominal pelvic TB.
ISSN:0972-9941
1998-3921