Endoscopy 1988; 20(6): 294-297
DOI: 10.1055/s-2007-1018200
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostic Yield and Endoscopic Patterns of Laparoscopy in the Diagnosis of Granulomatous Hepatitis

M. Moretó, M. Testillano, M. Zaballa, M. Suárez, S. Ibáñez
  • Gastroenterology Service, Digestive Endoscopy Unit, Hospital de Cruces, Faculty of Medicine, Bilbao, Spain
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Summery

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.