Diagnostic yield and endoscopic patterns of laparoscopy in the diagnosis of granulomatous hepatitis |
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Authors: | M Moretó M Testillano M Zaballa M Suárez S Ibá?ez |
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Affiliation: | Gastroenterology Service, Hospital de Cruces, Faculty of Medicine, Bilbao, Spain. |
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Abstract: | In reviewing 54 cases of granulomatous hepatitis (GH) diagnosed among 2,620 laparoscopies, we have been able to classify the capsular GH changes into five patterns: Macular, exudative, pinpoint, granular and cord-like. The exudative pattern was the most frequent one, and predominated in brucellosis. The granular pattern was most common in tuberculosis. Furthermore, 35 additional cases, in whom a laparoscopic diagnosis of GH was not confirmed by liver biopsy, showed a trend to a final diagnosis consistent with multifocal diseases, whenever laparoscopic pictures were similar to the patterns described herein. We speculate with the limits associated with the use of only a single biopsy sample. We conclude that laparoscopy permits the establishment of a tentative diagnosis of GH, which could provide us with valuable information about the usefulness of obtaining multiple hepatic biopsies. |
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