Efficacy of Laparoscopy in Diagnosis and Treatment of Chronic Abdominal Pain of Unknown Origin

2019 ◽  
Vol 85 (10) ◽  
pp. 1104-1107
Author(s):  
Jamil S. Samaan ◽  
Emily Chang ◽  
Nadav J. Hart ◽  
Evan T. Alicuben ◽  
Fadi Samaan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Unknown Origin ◽  
Definitive Diagnosis ◽  
Chronic Abdominal Pain ◽  
Positive Finding ◽  
Safe Procedure ◽  
Single Institution ◽  
Therapeutic Tool

Chronic abdominal pain of unknown origin is a challenging diagnosis encountered by clinicians. Patients often undergo an extensive workup and long periods of uncertainty without the establishment of a definitive diagnosis. Diagnostic laparoscopy is a relatively safe procedure that can be used as an effective diagnostic and therapeutic tool in treating this disease. This was a retrospective, single-institution study exploring the efficacy of diagnostic laparoscopy in treating chronic abdominal pain of unknown origin. More than 90 per cent of laparoscopies resulted in a positive finding, with adhesions being the most common. A total of 50 per cent of patients experienced resolution of symptoms on follow-up. Patients were overwhelmingly satisfied with their postoperative outcomes and willing to undergo the procedure again with their outcomes in mind.

A prospective observational study of the utility of early diagnostic laparoscopy for right lower abdominal pain: a safe and effective diagnostic and therapeutic tool

2019 ◽  
Vol 64 (2) ◽  
pp. 49-55
Author(s):  
Graeme JK Guthrie ◽  
Thomas Johnston ◽  
Anne Ewing ◽  
Russell Mullen ◽  
Stuart A Suttie ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Negative Impact ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Emergency Setting ◽  
Positive Finding ◽  
Therapeutic Tool ◽  
Surgical Trainees ◽  
Early Diagnostic

Background and aims Diagnostic laparoscopy is commonly performed for diagnosis of right lower abdominal pain and its use is increasing in the emergency setting. Some studies have reported that diagnostic laparoscopy and laparoscopic appendicectomy have advantages over conventional surgery. Many emergency surgeons now perform diagnostic laparoscopy for both clinically diagnosed appendicitis and when the diagnosis is in doubt. The aim of the present study was to assess whether the use of diagnostic laparoscopy is justified and safe for those admitted with right lower abdominal pain. Methods and results Data were collected prospectively on consecutive patients attending the acute surgical receiving unit with right iliac fossa pain or a suspected diagnosis of acute appendicitis. A total of 284 patients underwent diagnostic laparoscopy. Of them 233 (82%) had a positive finding at laparoscopy, 207 (88%) underwent appendicectomy, the majority of which were carried out laparoscopically. Surgical trainees performed the majority of operations and this did not have a negative impact on operative findings (p 0.856), operation performed (0.642), or operative duration (0.831). No intra-operative complications were sustained. Ultrasound examination was carried out in 49 patients, while CT was carried out in 24. Conclusion The results of the present study highlight the utility of early diagnostic laparoscopy as both a diagnostic and therapeutic tool in the acute setting.

scholarly journals DIAGNOSTIC LAPAROSCOPY IN CHRONIC AND RECURRENT ABDOMINAL PAIN MANAGEMENT

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Abhishek Jina ◽  
Abhinav Chaudhary ◽  
U C Singh
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Unknown Origin ◽  
Recurrent Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Chronic Appendicitis ◽  
Fluid Analysis ◽  
Invasive Method ◽  
Safe Technique

Background: Chronic abdominal pain is a common condition encountered by many surgeons in their clinic every day. Despite of availability of different tests in maximum cases the reason behind the pain remains unknown. Diagnostic Laparoscopy is a safe technique that can identify the cause of the pain without using any invasive method. In the present study, the use of diagnostic laparoscopy in the diagnosis and management of chronic and recurrent abdominal pain of unknown origin was investigated. Material and Methods: All the patients who visited the outpatient department with chronic abdominal pain were included in this study. All the demographic parameters were included and after careful investigation diagnostic laparoscopy were conducted in all these patients. The postoperative outcomes were also recorded in all the patients. Result: Total of 51 patients was included in this study. Among these patients 23 patients were male and 28 patients were female. Maximum of the patients were in the 31-40 years of age group. The most common pathology for chronic abdominal pain was chronic appendicitis (n=9, 18%) followed by Koch's abdomen and adhesions (n=8, 16%). There were 4 cases of Carcinoma of the gall bladder and 3 cases of metastatic disease with dissemination in the peritoneal cavity and ascitis. 3 cases of liver cirrhosis and 3 cases of endometriosis were also detected. 2 cases of ovarian cysts which were missed by USG were detected correctly by laparoscopy. There were two unusual cases, one of chronic ectopic pregnancy and another of Crohn's disease. All the above findings were confirmed by direct visualizing (86%), or by biopsy (74%) or by fluid analysis. There were no long term complications in our study. Conclusion: The present study concluded that laparoscopy is a safe and effective method for diagnosis of chronic abdominal pain. Keywords: Chronic abdominal pain, diagnostic laparoscopy, recurrent abdominal pain

Use of Abdominal and Pelvic Ultrasound in The Evaluation of Chronic Abdominal Pain

1993 ◽  
Vol 32 (3) ◽  
pp. 147-150 ◽  
Author(s):  
Rosemary E. Schmidt ◽  
Diane S. Babcock ◽  
Michael K. Farrell
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Medical Records ◽  
Chronic Abdominal Pain ◽  
Pelvic Ultrasound ◽  
Referring Physicians ◽  
Contrast Studies

The value of sonography in assessing chronic abdominal pain (CAP) in children, the characteristics of CAP, and the local pediatrician's practice in evaluating CAP are reported. Fifty-seven patients with CAP had abdominal and/or pelvic sonography; 56 were normal. One sonogram showed an ovarian cyst on the side opposite the CAP; the cyst later resolved. Pain was usually localized in the periumbilical area (56%). Follow-up data were obtained from referring physicians and patients' medical records. No serious diagnosis related to CAP was missed. After six months, CAP had resolved in 43% of patients. Of the responding physicians, 61 % indicated they would have used more and costlier contrast studies if ultrasonography had been unavailable.

scholarly journals Y Shaped Colonic Duplication Mimicking Intestinal Volvulus: A Case Report and Review of Literature

2021 ◽  
Author(s):  
Volkan Sarper Erikçi
Keyword(s):  
Abdominal Pain ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Chronic Abdominal Pain ◽  
Review Of Literature ◽  
Colonic Duplication ◽  
Intestinal Volvulus

Enteric duplications are rare congenital anomalies found anywhere from mouth to anus. Colonic duplications constitute about 13% of all enteric duplications. In this report a 6-year-old boy with chronic abdominal pain for a duration of last 2 years requiring intermittent hospital admissions was diagnosed as colonic duplication mimicking intestinal volvulus. Clinical findings are nonspecific and definitive diagnosis can only be made during surgical intervention and surgical treatment is advocated for all duplications. The topic is discussed under the light of relevant literature with a brief a brief literature review.

scholarly journals Use of methylene blue in the prevention of recurrent intra-abdominal postoperative adhesions

2017 ◽  
Vol 46 (1) ◽  
pp. 504-510 ◽  
Author(s):  
Octavian C. Neagoe ◽  
Mihaela Ionica ◽  
Octavian Mazilu
Keyword(s):  
Methylene Blue ◽  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Beneficial Effect ◽  
Adhesion Formation ◽  
Chronic Abdominal Pain ◽  
Postoperative Adhesions ◽  
Similar Time ◽  
History Of

Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-up period. Conclusions The use of methylene blue during adhesiolysis surgery appears to reduce the recurrence of adhesion-related symptoms, suggesting a beneficial effect in the prevention of adhesion formation.

scholarly journals Chronic abdominal pain in long-term spinal cord injury: a follow-up study

Spinal Cord ◽  
2016 ◽  
Vol 55 (3) ◽  
pp. 290-293 ◽  
Author(s):  
S D Nielsen ◽  
P M Faaborg ◽  
P Christensen ◽  
K Krogh ◽  
N B Finnerup
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Follow Up Study ◽  
Cord Injury

scholarly journals Role of diagnostic laparoscopy in chronic abdominal pain

2019 ◽  
Vol 7 (1) ◽  
pp. 217
Author(s):  
Sajid Hussain ◽  
Safia Haideri
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Chronic Abdominal Pain ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Therapeutic Value ◽  
Diagnostic Role ◽  
Surgery Department ◽  
Prospective Longitudinal

Background: Chronic abdominal pain is a common disorder both in general practice and in hospitals. Although patients with this type of pain may have undergone numerous diagnostic workups, including surgery, their pain remains a challenge to all known diagnostic and treatment methods. Laparoscopy can identify abnormal findings and improve the outcome in patients with chronic abdominal pain, as it allows surgeons to see and treat many abdominal conditions that cannot be diagnosed otherwise.Methods: A prospective longitudinal study was conducted from August 2016 to September 2017 in the Surgery Department of Vinayaka Missions Kirupananda Variyar Medical College, Salem. 50 patients with abdominal pain for 3 months and above were included in the study. Detailed history was recorded from patients and thorough clinical examination was performed. The findings were recorded in the proforma.Results: The most common laparoscopy finding among the study subjects was dense adhesions (26%) followed by abdominal TB (18%) and mesenteric lymphadenopathy (16%). 88% of the study subjects had a total relief of their abdominal pain and 6% of the patients felt that the pain was reduced and for the remaining 6% the pain was still persistent.Conclusions: The efficacy of diagnostic laparoscopy was 90% in the current study. Laparoscopy has an effective diagnostic role in evaluating patients with chronic abdominal pain, in whom conventional methods of investigations have failed to elicit a certain cause. The therapeutic value of diagnostic laparoscopy is also accepted, well-appreciated, and it cannot be underestimated.

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