Role of Diagnostic Laparoscopy in Management of Acute Abdomen of Unknown Aetiology

Abstract

Background: Acute abdominal pain (AAP) is a medical emergency, characterized by pain arising from the abdominal area, of non-traumatic origin with a maximum duration of five days. It is the most common surgical emergency, one of the most common reasons for referral to an emergency department (ED) and the most common cause for non-trauma-related hospital admissions. Aim of the Work: To evaluate the role of laparoscopy in the diagnosis and treatment of unexplained acute abdominal pain and establish it instead of conventional exploratory laparotomy. Patients and Methods: The current study is a prospective study randomized by closed envelope method which was carried out in Ain Shams University Hospitals. During the period from January 2018 and December 2018. Results: Maximum numbers of patients were of age 26 to 30 years (9 patients i.e. 30.0%). Least number of patients were from age group of 31-35 years. Female patients of acute abdomen were slightly more than that of male patients, due to increased number of cases of acute cholecystitis in females. Most common cause of acute abdomen in this study was acute appendicitis, while least common causes were pelvic inflammatory disease and mickel's diverticulum equally. Laparoscopy was done in all cases (100%); therapeutic laparoscopy was successful in 22 cases (73.30%) while 8 (26.7%) patients required to be converted to laparotomy. Complications related to laparoscopy in our study were observed in 15 out of 30 cases (50%); with shoulder pain is the most common one.