The significance of diagnostic laparoscopy in women with unknown origin ascites

Objective Ascites is a common sign in the clinical practice,but the identification of etiological factors sometimes are difficult.This study aimed to investigate the diagnostic and therapeutic significance of laparoscopy in women with ascites.Methods Thirty three female patients with ascites,and without significant medical or chirurgic diseases or positive results in the examination of paracentesis abdominis,were recruited from January 2002 to January 2012.Clinical features,pathological findings and the results of follow-up were collected and analyzed retrospectively.Results Twenty-nine patients obtained definite diagnosis after laparoscopic examination,including twenty three peritoneal tuberculosis,three mucinous epithelial ovarian cancers and three primary peritoneal carcinomas.One patient with chylus ascites was diagnosed as lymphoma after lymphonodus biopsy.There were no positive findings in other three patients after laparoscopic examination,in which one was found abnormal auto-antibody and got remission after anti-autoimmune therapy;another one was found hypothyroid and got remission after oral thyroxine;PET/CT scan showed abnormal fluorodeoxyglucose metabolism in the right ovary in the third patient.Right oophorectomy was performed and pathologic diagnosis showed endometriosis,polycystic ovary and luteoma,and the ascites and clinical symptom were improved after the surgery.Conclusion Laparoscopy is an useful technique to make a quick and accurate diagnosis and to adopt an effective treatment for women with unknown origin ascites.