Laparoscopic Evaluation of Acute Abdominal Pain

Abstract

It is often difficult to tell which patients with acute abdominal pain will require surgery. We studied 79 patients with acute abdominal pain who were thought likely, though not unequivocally, to have abdominal problems requiring surgery. All underwent laparoscopy and only 27 subsequently required open laparotomies. The accuracy rate as determined by followup was 99%. The liberal use of laparoscopy for uncertain cases of appendicitis resulted in a negative appendectomy rate of only 2.2%. There were no deaths and no major complications.

Introducing diagnostic laparoscopy for patients with suspected acute appendicitis

“…The operating time in this group was short and no postoperative complications were seen. Few complications have been reported previously by others, suggesting that diagnostic taparoscopy can be considered safe for the patient [18,38,50,53]. There were only six male patients in this group.…”

“…However, the possible advantages of laparoscopy as a diagnaostic tool in patients with acute abdominal pain is not discussed frequently among surgeons [14,18,24,29,34,37], They however frequently discuss the possible advantages of laparoscopic appendectomy [25,42,52].…”

Laparoscopy for Diagnosis and Treatment of Acute Abdominal Pain

“…In various reports, in 66% to 80% of the acute abdomen cases diagnosed by laparoscopy, treatment was realized in the course of the procedure. 2,3,6,8 In one study on 119 patients with acute ab-dominal pain, 9 the diagnosis could not be made by laparoscopy in two cases, and laparotomy was required. In our study, the diagnosed surgical pathology was treated by laparoscopy in 36 patients (84%); conversion was required in 7 (16%).…”