Role of Diagnostic Laparoscopy in Cases of Acute and Chronic Abdominal Pain

Abstract

BACKGROUND We wanted to evaluate the efficacy of laparoscopy as a diagnostic tool in the evaluation of pain abdomen, compare it with clinical examination and common radiological investigations like x-ray erect abdomen and ultrasound abdomen, demonstrate the occasions in which it is useful as a therapeutic tool and evaluate the benefits and complications of diagnostic laparoscopy. METHODS 100 cases of pain abdomen who presented to the outpatient and emergency departments were admitted and evaluated. They consisted of both male and female patients. The cases consisted of both acute and chronic abdomen evaluated over a period of 2 years i.e. from January 2017 to January 2019. RESULTS 100 cases of pain abdomen who presented to the outpatient and emergency department were evaluated. Diagnostic laparoscopy could diagnose 68 out of 79 cases of acute pain abdomen and 20 out of 21 cases of chronic pain abdomen. 49 out of 79 acute cases and 13 cases out of 21 chronic cases required surgery. 12 cases could not be diagnosed, out of these 9 patients had symptomatic relief. There were no complications in the series. CONCLUSIONS Diagnostic laparoscopy is simple, safe, easily available and diagnostically accurate, but it is invasive, traumatic and not the first choice for diagnosis. It is mostly useful for those with abdominal pain where definite cause could not be diagnosed with clinical examination or radiological investigations. It has reduced the number of negative laparotomies and in those cases requiring laparotomy.

Laparoscopy in management of surgical causes of acute verses chronic pain abdomen in adults visiting tertiary care hospital in Telangana, India

“…6). 17,18 Renal/ureteric stones (3/1.8%), in this study were very less compared with Thakur et al 74 (14.2%). 2 TB abdomen (1/1.2%) was less in this study when compared with Brahman et al (5%) and Rao et al (3%).…”

“…2 TB abdomen (1/1.2%) was less in this study when compared with Brahman et al (5%) and Rao et al (3%). 17,18 Cholecystitis (18/10.7%), diverticulitis (3/1.7%) was less and hernia (7/4.2%) was more in this study compared to study by Brahman et al, 4 (5%) and 2 (2.5%) respectively (shown in Table 6). 17 Undiagnosed were 1 (0.6%) and 3 (1.2%) patients of AAP and CAP, respectively.…”

“…Rao et al study 18. Also appendicitis was 32% which was very high in study by Thawait et al and Subramaniam et al 79% diverticulitis was 0.6% in current study which was very low, compared with study by Bahram et al it was 5% (shown in Table6) 16,17,19.…”