Medisur (Apr 2016)
Laparoscopic Appendectomy for the Treatment of Chronic Abdominal Pain of Unknown Origin in the Right Lower Quadrant in children
Abstract
Background: several studies address the use of laparoscopic appendectomy in the treatment and elimination of chronic abdominal pain of unknown origin in the right lower quadrant. Objective: to describe the outcomes of laparoscopic appendectomy in the treatment of chronic abdominal pain of unknown origin in the right lower quadrant and the pathological results of the vermiform appendices removed. Methods: a case series study was conducted in the Pediatric Hospital of Cienfuegos from January 2011 through December 2012. It included patients younger than 19 years with chronic abdominal pain of unknown origin in the lower right quadrant treated with laparoscopic appendectomy. Age, sex, signs and symptoms, duration of pain and pathological diagnosis were analyzed. Results: eighteen patients aged 6 to 16 years (mean age 11.44 years) underwent laparoscopic appendectomy, 44.4% were male and 55.6% female. The duration of pain ranged from one to 24 months, with a mean of 7.33. Sixty one point one percent of the cases were pathologically diagnosed with acute appendicitis. Chronic appendicitis and other appendix conditions were uncommon. Chronic appendicitis was found in two cases and in two others, the vermiform appendix was normal. Patients were evaluated a month and three months after surgery. The pain disappeared in 17 patients who were regarded as cured or “pain-free". Seventeen surgeries were performed on an ambulatory basis. Conclusions: treatment of chronic abdominal pain of unknown origin in the right lower quadrant with laparoscopic appendectomy was effective to eliminate or minimize pain in pediatric patients.
