Assessment of Diagnostic Laproscopy in Chronic Abdominal Pain at Tertiary Care Hospital

Abstract

Objective: The objective of this study was to find out the diagnosis of diagnostic laparoscopy in patients having chronic abdominal pain.

Study Design: Descriptive / cross sectional study

Place and Duration of Study: This study was conducted at the Surgery Department of PMC hospital and PUMHS Nawabshah from February 2014 to March 2015.

Materials and Methods: All the undiagnosed cases of chronic abdominal pain (by conventional methods and investigations such as clinical examination, urine examination, US abdomen etc),  abdominal pain more than 3 months, cases age more than 18 years either gender and clinically diagnosed as chronic were selected in this study,  while all the cases with known cause of pain, Acute inflammatory disease,  cases having acute intestinal obstruction, coagulation abnormalities,  critical illness, severe/decompensated cardiopulmonary failure and medically unfit for anaesthesia and surgery were not selected in this study. Diagnostic laparoscopy was performed in all selected cases and findings were entered in proforma.

Results: Total 45 patients underwent diagnostic laparoscopy majority of the young patients was found. Female were found in the majority 60% as compare to males 40%. 13 (28.88%) patients had pain in right iliac fossa, 08 (17.78%) patients had hypogastrium pain, 10 (22.22%) cases were found with whole abdominal pain, 10 (22.22%) patients had pain in left iliac fossa and 04 (8.89%) patients were noted with pain at right hypochondrium.  According to laparoscopy findings, appendicitis and adhesions were most common 14(31.11%) and 10(22.22%) respectively, following by Abdominal tuberculosis, Hernia, Mesenteric lymphadenopathy, Ovarian cyst and Dense  adhesions + Thickened gall bladder wall with percentage of 06(13.33), 03(6.67%), 02(4.44%), 04(8.89%) and 02(4.44%) respectively, while 04(8.88%) cases were noted without any disease.

Conclusion: Diagnostic laparoscopy in good tool for diagnosis of chronic abdominal pain, according to the assessment the commonest basis of chronic recurrent abdominal pain in this study was appendicitis followed by abdominal tuberculosis and adhesions.