Diagnostic laparoscopy in acute abdominal pain : 5-Year retrospective series

Abstract EN

Background: In acute abdomen, sometimes it is difficult to achieve diagnosis by the traditional method of investigation and policy of “Wait and See.” Objective: To analyze the efficacy of diagnostic laparoscopy in acute abdominal pain.

Setting: Surgical department, Salmanyia Medical Centre.

Design: Retrospective study.

Method: A study of 100 consecutive cases of acute non-specific abdominal pain between September 1995 and June 2000 who had diagnostic laparoscopy.

The personal characteristics were recorded along with pre-operative diagnosis and final diagnosis.

The presenting symptoms and any therapeutic procedure performed were noted.

Result: One hundred patients had diagnostic laparoscopy within 48 hours of admission due to acute non-specific abdominal pain.

There were 18 males and 82 females.

The mean age of this group was 31 ranging from 16 to 62 years.

The patients presented with various complaints which included abdominal pain in 39, pain and anorexia in 14, abdominal pain with anorexia and vomiting in 34, abdominal pain and fever in 11 and abdominal mass in 2 patients.

The mean hospital stay was 3.9 days ± 2 days (1-15 days) and the average operative time was 56.8 minutes (35-127 minutes).

A definitive diagnosis was achieved in 98 patients (98%) using diagnostic laparoscopy.

Two patients had to be converted to formal open laparotomy.

A therapeutic laparoscopic procedure was performed in 78 patients.

The laparoscopic findings were acute appendicitis in 73 patients, pelvic inflammatory disease in 14, significant ovarian cysts in 7, endometriosis in 3, ectopic pregnancy in 2 and Meckel’s diverticulitis in 1.

Conclusion: In this study, the diagnosis was achieved through laparoscopy in 98% of cases.