Role of Diagnostic Laparoscopy in Chronic Abdominal Pain

Abstract

Background: In routine surgical practice there are a lot of cases of abdominal pain in which
definite diagnosis is not possible despite multiple investigations. In many cases laparotomy is the
only alternative where it proves to be an important tool for accurate diagnosis and management.
The aim of this study was to evaluate and establish the role of diagnostic laparoscopy for chronic
abdominal pain.
Material and Methods: In this prospective study patients with abdominal pain of more than 3
months duration, coming to surgical OPD of Shalamar Hospital, Lahore, over a period of 3 years
were considered for diagnostic laparoscopy if diagnosis was not possible with conventional
methods. Diagnostic laparoscopy was performed in 80 patients by one surgeon and disease was
also treated laparoscopically where possible. The correlation between preoperative,
laparoscopic and pathological diagnosis was also assessed.
Results: Laparoscopy yielded positive findings in 78 (97.5%) cases. Abdominal Tuberculosis
43.75% (n=35), Recurrent Appendicitis 26.25% (n=21) and Postoperative Intra-abdominal
adhesions 17.5% (n=14) were major finding,.although metastatic adenocarcinoma 7.5% (n=6),
Ileoileocolic intussusception1.25% (n=1) and retroperitoneal masses 1.25% (n=1) were also
found. Therapeutic procedures were performed in 36 patients (laparoscopically in 35).
Laparoscopic biopsies were taken in cases of abdominal Tuberculosis and malignancies. So the
patients who remained undiagnosed by routine investigations were not only diagnosed but also
treated laparoscopically where possible.
Conclusion: Laparoscopy is a useful diagnostic tool in cases of chronic abdominal pain where
other investigations fail to diagnose.