Evaluation Of The Role Of Diagnostic Laparoscopy Innon Specific Abdominal Pain & Its Correlation With Clinical & Radiographic Findings
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
BACKGROUND: Non specific abdominal pain is a diagnostic challenge; such patients frequently seen by many physician & undergoing vast diagnostic workup without making definitive diagnosis at the end & got unsatisfactory discharge, render the patient for readmission with the similar complaints later on with additional psychological embarrasment.Incorporation of laparoscopy earlier(within 24 hrs.) not only make definitive diagnosis but mostly at same time therapeutic too & avoiding unnecessary laparotomies; saves time,cost, avoiding unnecessary investigations, reducing hospital stay, readmission rates, mental /psychological satisfaction to patient & allow the surgeon to discharge patients.OBJECTIVE: Our aim is to evaluate the role & efficacy of laparoscopy in diagnosis as well as management of abdominal pain in thisstudy.MATERIALS& METHODS: We performed a prospective study of 220 patients who underwent diagnostic laparoscopy for non specific abdominal pain from July 2016 to December 2017at Surgical as well as gynaecological ward, M.G.M. MEDICAL COLLEGE AND MYH Indore.The Pain in all these patients was either of unclear etiology or not responding to treatment given after clinical assessment. It include acute (<7 days duration) as well as chronic abdominal pain (>7 days duration). Patients less than 12 years excluded from the study. Most patients are subjected to diagnostic laparoscopy and procedure with few kept under observation.The laparoscopy is categorized under two headings. 1.Within 24 hours of admission 2. Greater than 24 hours of admission.RESULTS:Out Of 220 patients studied for diagnostic laparoscopy with diagnostic accuracy of (64%); 160 patients(73%) are females with most commonly presenting between 20-30 yrs of age with mostly abdominal pain last between 3 month to 6 month duration (18.2%).max patient 171 (78%)having pain localized to right iliac fossa &periumbilicalregion.Most common 76 (34%) patients suffered from gynaecological pathology. 2 nd most common 62 (28%) found inflammation of appendix. definitive clinical diagnosis of appendicitis is exempted from the study.7 patients shown negative laparoscopy & 5 patients are needed to converted to open procedure. CONCLUSION:Gynaecologicalpathology, incidentally found appendicitis, &post operative adhesions form a majority of cause for causing non specific abdominal pain. Diagnostic laparoscopy is a safe and effective modality for the diagnostic as well as at the same time therapeutic management too for such patients. Due to improvement in instrumentation & greater experience in laparoscopy, the procedure no longer limited to visualization.
Authors and Affiliations
Ankur Jain, Km Preeti
Keywords
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- EP ID EP381855
- DOI 10.9790/0853-1709013944.
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