Sharma′s ascending colonic adhesion: A new sign in abdomino pelvic tuberculosis with infertility

Context: Abdominopelvic tuberculosis (TB) is involvement of abdominal and pelvic viscera and peritoneum with TB. Aims: To evaluate the laparoscopic findings in abdominopelvic TB with reference to a new ascending colonic adhesion. Subjects and Methods: Twenty-five cases of abdominopelvic TB with diagnosis made by demonstration of acid-fast bacilli on microscopy or culture on endometrial or peritoneal biopsy or demonstration of epithelioid granuloma on biopsy or positive polymerase chain reaction to Mycobacterium tuberculosis on endometrial or peritoneal biopsy were enrolled in the study. Laparoscopy was performed in all abdominopelvic TB cases. Results: Definitive findings of abdominopelvic TB (caseous nodules, tubercles, or beaded tubes) were observed in 12 (48% of cases), and probable findings of abdominopelvic TB were observed in 13 (52%) cases (congested, hyperemic, and blocked tubes; hydrosalpinx, pelvic, abdominal, and perihepatic adhesions; and straw-colored fluid). Conclusions: The new sign Sharma's ascending colonic adhesion appears to be promising in early diagnosis of abdominopelvic TB. However, larger studies are advised before the new sign can be routinely recommended in clinical practice.