EVALUATION OF THE ROLE OF DIAG OSTIC LAPAROSCOPY IN ACUTE ABDOMEN

Abstract

Acute abdomen presents one of the most difficult challenges in clinical edrCIIle ar>d ;mplies sever abdominal pa;n aris;ng rather suddenly and often iess thai' 24 'lours ;n duration (Burova eta/. 1994).

Its causes are often conditions that require immediate operation, and the dec1s1on to operate is dependant on the ability to diagnose the problem accurately as based on a complete medical history, thorough physical exammation. and pertinent diagnostic test. The primary goal is to establistll whether the acute abdominal condition requires operative intervention, and when it must be performed (Stephen and James, 1994).

Unfortunately, even the most experienced clinicians make a correct C:1n1ca1 diagnos1s of acute abdominal pain one four occasions out of five, younger aoctors and those who practice in the community are only right half the time (Julian <994!

There are acute abdominal conditions in which it is difficult to establish an indicative diagnosis before laparotomy. A diagnosis is important in plan1ng the ngllt abdominal incision or to avoid an unnecessary laparotomy.. D1agnost1c non-invas;ve procedures such as X-ray studies do not always appear corc1us1ve Diagnostic laparoscopy is tile only technique, whicll can visualize tile abdomen and by establishing an adequate diagnosis, permits the surgeon to p1an the r.ght abdom;nal approach (Cuesta eta/., 1998)

c..aparoscopy can be a valuable diagnostic tool for determining the cause of abdom;nal pain (Chung eta/., 1998). Acute right lower quadrant pain and tenderness. which may be acute appendicitis, can be evaluated by laparoscopy. The diagnos·ls of acute appendicitis when determined on clinical grounds only, results in 20% to 30% error rate as determined by a histological 'lormar appendix Th1s high false positive rate has been considered acceptable because of sever morbidity and mortality caused by appendices perforation