Role of Diagnostic Laparoscopy - In doubtful Abdominal and Pelvic pathologies

Abstract

Introduction: Acute abdomen refers to severe abdominal pain that occurs in less than 24 hours. Its management requires multimodality approach. Diagnosis is a key aspect in acute abdomen. There are some non specific conditions where diagnostic laparoscopy (DL) can be done in order to diagnose the cause of acute abdomen. Moreover DL can be used for surgical intervention as well if needed. Aims & Objective: This study is intended to determine the various clinical presentations of acute abdomen, investigations and indications for DL and its outcome. Materials & Methods: This is a prospective descriptive study that was conducted among 80 patients admitted to surgery ward in Prathima Institute of Medical Sciences, Karimnagar. Patients underwent DL for acute abdominal and pelvic pathologies and results were analyzed on the basis of age and gender distribution, indications, diagnosis, procedure and management. Results: Among 80 patients, 40 percent of them were in 11 to 30 years of age; 47.5% were male while 52.5% were females. 80% patients had pain abdomen as indication for DL and in 5% patients, it was ascites for evaluation. 15% patients underwent staging laparoscopy for diagnosed GI malignancy. Most common diagnosis was Koch's Abdomen (22.5%) followed by GI malignancy (20%) and adhesions (15%). Among more than half of patients, sample was taken for tissue biopsy. 30 cases had definitive procedure performed laparoscopically, whereas, 10 cases underwent open procedure. Conclusion: DL is helpful in confirming a doubtful diagnosis and it reduces chances of unnecessary laparotomies. It is superior to imaging modalities and makes definitive diagnosis. It is safe, less time consuming, cosmetic with lesser complications and lesser morbidity and mortality

Keywords

• diagnostic laparoscopy
• acute abdomen
• koch's abdomen
• adhesiolysis