Diagnostic Laparoscopy in Acute Abdominal Pain

Abstract

Acute abdominal pain is a common surgical problem with which the patients present to the surgical department. Abdomen is considered as a pandoras box by many surgeons as it is very difficult to diagnose the problems definitively in many occasions in spite of the various technological advancements in the modern medicine by non-invasive methods. Many a time laparotomy was done to arrive at a diagnosis in the past. This study was done to establish the efficacy of diagnostic laparoscopy in establishing a definitive diagnosis in cases of acute abdominal pain patients. Diagnostic laparoscopy is a minimally invasive procedure that not only helps in the diagnosis but also to treat the patients with less morbidity. The study was done between January 2015 to December 2017 in Sree Balaji medical college and hospital. 363 patients with acute abdominal pain were included in the study. All the patients were subjected to thorough physical examination, biochemical and radiological investigations and endoscopies to arrive at a definitive diagnosis. Diagnostic laparoscopy was done for all these patients and the findings are correlated with the preop diagnosis and histopathological examination was also done for the specimen retrieved during laparoscopy. newlineDiagnostic laparoscopy established the diagnosis in 356 patients (98.1%). Diagnostic laparoscopy failed to yield a diagnosis in 7 patients (1.9%). Whereas CECT scan of the abdomen established diagnosis in 84.5% of cases and Ultrasonogram was useful in only 64.5% of cases. These figures indicate 98.1% of positive predictive rate for Diagnostic laparoscopy in acute abdomen in this study. Positive predictive rate for Diagnostic laparoscopy is about 100% for cholecystitis, ovarian cyst, adhesive colic, mesenteric lymphadenitis, omental torsion and pyosalpinx and 96.8% in cases of appendicitis. The fact that 98.1% diagnostic confirmation achieved in our series speaks for the advantage of Diagnostic laparoscopy as a diagnostic modality in the diagnosis of Acute abdominal conditions. The l