scholarly journals Evaluation of efficacy of laparoscopy in patients with chronic abdominal pain

2017 ◽  
Vol 4 (6) ◽  
pp. 1856
Author(s):  
Sanjay Prasad ◽  
Suraj Jain ◽  
Advait Prakash ◽  
Ajeet Gautam ◽  
Mohan Gadodia ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Psoas Abscess ◽  
Demographic Data ◽  
Tertiary Care ◽  
Cost Effective ◽  
Abdominal Tuberculosis ◽  
Pelvic Abscess ◽  
Chronic Abdominal Pain ◽  
Chronic Appendicitis

Background: Chronic abdominal pain is a major cause of surgical dilemma. Patients with chronic abdominal pain usually undergo a battery of investigations without yielding much in diagnosis. The pain in such patients therefore becomes chronic and perpetual source of discomfort. This study was under taken to assess the efficacy of performing diagnostic and therapeutic laparoscopy in patients with chronic abdominal pain for longer than 3 weeks or more.Methods: This prospective study was performed at a tertiary care level hospital. All patients undergoing laparoscopy for chronic abdominal pain were included in the study from December 2013 to June 2015. The patient’s demographic data, duration of pain, diagnostic studies, intra-operative findings during laparoscopy, interventions performed and follow-up were recorded and evaluated.Results: A total of 50 patients, 22 females and 28 males, between age range of 10 years to 60 years underwent diagnostic laparoscopy for the evaluation and treatment of chronic abdominal pain. The average duration with pain was 10.38 weeks (range 4-32 weeks). Findings included abdomen chronic appendicitis in 15 patients, abdominal tuberculosis in 11 patients, ovarian cyst five patients, sub acute intestinal obstruction in five patients and liver abscess four patients. Meckel’s diverticulum, ectopic pregnancy, pelvic abscess, appendicular lump, Psoas abscess and typhilitis were noted in one patient each. Various procedures in accordance with pathology were performed. 92% of patients had pain relief at the time of follow up.Conclusions: Diagnostic laparoscopy is a better, cost-effective, and efficient method of establishing the diagnosis in patients with chronic abdominal pain.

scholarly journals The role of laparoscopy in diagnosis of patients with chronic abdominal pain

2016 ◽  
Vol 4 (1) ◽  
pp. 326 ◽  
Author(s):  
Pradeep Saxena
Keyword(s):  
Abdominal Pain ◽  
Clinical Picture ◽  
Descriptive Analysis ◽  
Abdominal Tuberculosis ◽  
Chronic Abdominal Pain ◽  
Diagnostic Dilemma ◽  
Chronic Appendicitis ◽  
Fluid Analysis ◽  
Conclusive Diagnosis

Background: Chronic abdominal pain still remains one of the leading clinical problems presenting to physicians. Reaching a definitive diagnosis and prompt management is usually delayed because invasive investigations are frequently required to come to a conclusive diagnosis. The aim was to study the varied clinical picture of chronic abdominal pain and evaluate the role of laparoscopy in reaching a conclusive diagnosis in these patients.Methods: A prospective and retrospective study of 142 patients of chronic abdominal pain who underwent diagnostic laparoscopy in our surgery department from June, 2006 to December, 2015 was done. A descriptive analysis of data collected from case records of these patients was done to study the varied clinical picture, laboratory reports, radiological findings, laparoscopic findings and histological reports. The usefulness of laparoscopy to confirm the diagnosis and in clinical management of these patients of chronic abdominal pain was evaluated.Results:Laparoscopy was performed in 142 patients of chronic abdominal pain with unsettled diagnosis. A conclusive diagnosis could be made in 136 of these patients. The common causes of chronic abdominal pain were abdominal tuberculosis, adhesions, bands, small intestinal strictures, chronic appendicitis, abdominal malignancy and various gynecological diseases. Gynecological problems causing chronic abdominal pain were pelvic inflammatory disease, ovarian cyst, tubo-ovarian mass, hydrosalpinx, fibroid uterus, bulky uterus, endometriosis. Thus laparoscopy provided positive diagnosis of in 136 (95.77%) patients based on laparoscopic findings, histological reports, ascitic fluid analysis and cytology.Conclusions:In patients suspected to have abdominal pathology early laparoscopy may be useful to establish a conclusive diagnosis with acceptably low morbidity (<5 %). An early resort to laparoscopy can resolve the diagnostic dilemma and early treatment can be instituted.

scholarly journals Laparoscopy: a tool for undiagnosed pain abdomen

2018 ◽  
Vol 5 (10) ◽  
pp. 3350
Author(s):  
Arpit Sharma ◽  
Deepak Sethi ◽  
Anjali Sethi
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Tertiary Care ◽  
Care Hospital ◽  
Chronic Appendicitis ◽  
Pain Abdomen

Background: Diagnostic laparoscopy has been in the armamentarium of the surgeon and gynaecologist for many years as a useful technique for evaluating pelvic pathology and it is now one of the most frequently performed laparoscopic procedures. The purpose of this study is to evaluate the role of diagnostic laparoscopy in undiagnosed pain abdomen. The Objectives of this study is to evaluate laparoscopy as a diagnostic tool in cases of undiagnosed abdominal pain where clinical symptoms and investigations are not conclusive and to evaluate benefits and complications of diagnostic laparoscopy.Methods: The study was done in 60 patients, presenting with chronic undiagnosed pain abdomen to a tertiary care hospital. All the patients were operated under general anesthesia in supine position. Diagnostic laparoscopy was done using 3 ports, one umbilical 10 mm, other two depending upon possible pathology. After the study, the data was analyzed to evaluate the role of laparoscopy in undiagnosed abdominal pain.Results: Out of 60 patients, 44 were female and 16 males. On diagnostic laparoscopy, findings were- chronic appendicitis - 31, chronic appendicitis with left ovarian cyst - 1, endometriosis with adhesions - 3, PID - 5, PID with adhesions - 3, suspected TB (GI/Genital) - 4, adhesions - 12, negative diagnostic lap - 1. So it may be concluded that diagnostic laparoscopy is a very useful tool to establish diagnosis in patients with undiagnosed abdominal pain with the following benefits are, superior diagnostic ability, better visualization of the abdominal cavity including the paracolic gutters and the pelvis, able to pin point the sites of adhesions with adhesiolysis during the same procedure, retrieval of specimen for histopathological examination, management of the pathology during the same procedure, avoiding unnecessary laparotomy, low complication rate.Conclusions: Laparoscopy is an efficient tool in the armamentarium of the surgeon to diagnose the patients of undiagnosed pain abdomen with numerous benefits and minimal complications.

scholarly journals The role of diagnostic laparoscopy in the era of modern imaging techniques: a study from a single center

2019 ◽  
Vol 6 (5) ◽  
pp. 1578
Author(s):  
Muzafar Yousuf Parray ◽  
Ajaz Ahmad Malik ◽  
Yaqoob Hassan ◽  
Ishfaq Ahmad Wani ◽  
Munir Ahmad Ahmad Wani ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Liver Disease ◽  
Diagnostic Laparoscopy ◽  
Abdominal Tuberculosis ◽  
Final Diagnosis ◽  
Diffuse Liver Disease ◽  
Chronic Appendicitis ◽  
Focal Liver Disease ◽  
Abdominal Malignancy

Background: Despite the tremendous progressive evolution in the field of medicine, wherein, most of the diseases can be diagnosed based on history, clinical examination and investigations, there are quite a number of diseases which remain undiagnosed. It is here, where the role of diagnostic laparoscopy becomes important to reach to a conclusion for further management of patients.Methods: This study comprising of 70 patients undergoing diagnostic laparoscopy at SKIMS over a period of 4 years. This study was done to evaluate the role of diagnostic laparoscopy in patients with acute and chronic abdominal conditions wherein final diagnosis could not be achieved after all necessary imaging, serological, cytological, and microbiological investigations.Results: Out of 70 patients subjected to diagnostic laparoscopy in our study, the commonest indication was as cites of undetermined etiology (42.9%) followed by chronic abdominal pain (25.7%) diffuse liver disease (11.4%) acute abdominal pain (SAIO, cholecystitis, acute appendicitis, PID, endometriosis) (5.7%) abdominal tuberculosis (4.3%) focal liver disease (2.9%) bleeding per rectum (2.9%) abdominal malignancy (2.9%) and primary infertility (1.4)%. The post diagnostic laparoscopy outcome (final diagnosis) were abdominal malignancy 22 (31.4%) followed by abdominal tuberculosis 16 (22.9%) diffuse liver disease 6 (8.6%) focal liver disease 6 (8.6%) PID 4 (5.7%) SAIO 4 (5.7%) post-operative pelvic adhesions 3 (4.3%) Meckel’s diverticulum 2 (2.9%) abdominal plus pulmonary tuberculosis 1 (1.4%), endometriosis 1 (1.4%), ovarian cyst 1 (1.4%), pseudomyxoma peritonei 1 (1.4%), chronic appendicitis 1 (1.4%) and inconclusive 2 (2.9%). Diagnostic laparoscopy confirmed pre-operative diagnosis in 10 (14.3%) patients. In 29 (41.4%) patients pre-operative diagnosis was corrected by diagnostic laparoscopy. In 29 (41.4%) patients diagnosis was made only after diagnostic laparoscopy.Conclusions: Diagnostic laparoscopy is a safe, quick, and effective adjunct to non surgical diagnostic modalities, for establishing a conclusive diagnosis with high percentage of accuracy in diagnosis and impact in further management in selected patients.

scholarly journals Role of Diagnostic Laparoscopy in Unexplained Chronic Abdominal Pain

2015 ◽  
Vol 10 (2) ◽  
pp. 9-14
Author(s):  
Mohammad Shafiul Alam ◽  
Md Mahbubur Rahman ◽  
Md Siddique Ahmad
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Care Facility ◽  
Health Care Facility ◽  
Armed Forces ◽  
Abdominal Tuberculosis ◽  
Chronic Abdominal Pain ◽  
Definitive Treatment ◽  
Diagnostic Modality ◽  
Cross Sectional

Introduction: Patients with chronic abdominal pain get repeated hospitalization. They fail to perform their duties continuously and thus become burdens for their families. These patients are occupying a good number of indoor beds with dilemmatous diagnosis. This indirectly creates pressure on health care facility and plays a notable negative role to our economy.Aim: To determine the usefulness of diagnostic laparoscopy for diagnosis and also to find out the therapeutic scope in unexplained abdominal pain.Method: This is a prospective cross-sectional observational study and was carried out in the Department of surgery, CMH, Dhaka over a period of 2 years from July 2008 to June 2010.Results: Among the study population, 8 (26.67%) patients underwent abdominal and pelvic operation in the past for various diseases. The duration of chronic abdomen pain in these patients was between 6 months to 24 months or more. Twenty five (83.5%) cases out of 30 were diagnosed. Postoperative band & adhesions (28%), recurrent appendicitis (24%), endometriosis (16%), abdominal tuberculosis (16%) were the most frequently found etiologies of unexplained chronic abdominal pain in these patients. Eighteen (59.4%) patients underwent therapeutic procedure during Diagnostic Laparoscopy and biopsy was taken from 7 (23.1%) patients. Patients were provided treatment according to histopathology report. Patients were followed up for 2 years at Out Patient Department (OPD) at CMH. Around 75% cases became symptom free following therapy, 15% had short term minimal symptom for 6 months and persistent pain was present in small percent of patients (10%). 09 JAFMC Bangladesh. Vol 10, No 2 (December) 2014Conclusion: Laparoscopy is a safe diagnostic modality. It is useful to establish diagnosis or for exclusion of suspected abdominal pathology whenever chronic abdominal complaints remain undiagnosed. It also provides an opportunity for definitive treatment by laparoscopy or open surgery in unsuspected lesions.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

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

scholarly journals A Retrospective Analysis to Validate the Alarm Signs Used in the CEDAP-Plus Study

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Hou-De Zhang ◽  
Mu-Xian Lin ◽  
Qu Zhang
Keyword(s):  
Abdominal Pain ◽  
Capsule Endoscopy ◽  
Gastrointestinal Stromal Tumors ◽  
Demographic Data ◽  
Chronic Abdominal Pain ◽  
Chronic Anemia ◽  
Stromal Tumors ◽  
Loss Of Weight ◽  
Small Intestinal ◽  
Low Sensitivity

Background and Study Aim. This study aimed to validate the alarm signs used in the 2007 German CEDAP-Plus study for indicating capsule endoscopy in patients who have idiopathic chronic abdominal pain. Patients and Methods. We retrospectively reviewed the cases of all patients who underwent capsule endoscopy at our institution between August 2007 and August 2009 for chronic hitherto undiagnosed abdominal pain, despite previous investigations. The demographic data, indications, findings, and diagnoses were recorded, as were the alarm signs (i.e., 10% loss of weight within 3 months, suspected small intestinal bleed or chronic anemia, and laboratory indications of inflammation). Results. Alarm signs were found in only 4 of the 62 included patients. Capsule endoscopy revealed findings that led to diagnoses of Crohn's disease (), tuberculosis (), gastrointestinal stromal tumors (), and hookworm (); these diagnoses included 100% (4/4) of the patients with alarm signs, but only 8.6% (5/58) of patients without them. However, 55.6% (5/9) of patients with clinically capsule endoscopy findings reported no alarm signs. Conclusions. Although selecting patients based on the alarm signs may increase the yield of capsule endoscopy, the alarm sign criteria appear to have low sensitivity.

scholarly journals Surgical management of abdominal tuberculosis in a tertiary care referral center

2020 ◽  
Vol 7 (3) ◽  
pp. 842
Author(s):  
Subramaniam Swaminathan ◽  
C. S. Naidu ◽  
P. P. Rao
Keyword(s):  
Surgical Management ◽  
Diagnostic Laparoscopy ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Barium Meal ◽  
Diagnostic Procedures ◽  
Exploratory Laparotomy ◽  
Abdominal Tuberculosis ◽  
Final Diagnosis ◽  
Definitive Management

Background: Abdominal tuberculosis encompasses gastrointestinal, visceral and peritoneal forms of tuberculosis in different proportions. Their clinical presentation and radiological findings are varied and non-specific often warranting surgical intervention either for confirmation of diagnosis or for definitive management.  It is not very clear as of now as to which type of patients would require surgical intervention for diagnosis or treatment of abdominal tuberculosis. This study aims to profile such patients accurately to revalidate the need for surgical intervention in cases of abdominal tuberculosis.Methods: This study is a retrospective descriptive observational study wherein the documents of patients whose final diagnosis was confirmed as ‘Abdominal Tuberculosis’ from January 2011 to December 2013 were analysed. Their demographic and clinical profile, hematological, biochemical and radiological investigations including barium meal follow-through, ultrasonography, CT scan abdomen, colonoscopy and biopsy, HIV status and ascitic fluid analysis were analysed. Patients in whom diagnosis was not confirmed by these investigations, and therefore underwent diagnostic laparoscopy or exploratory laparotomy were studied. Simultaneously, patients in whom, the diagnosis was confirmed, but still underwent surgical intervention for therapeutic purposes were also analysed.Results: It was found that 44 out of 54 patients (81.4%) underwent surgical procedure.  28 (52%) required surgical intervention for confirmation of diagnosis (diagnostic procedures: diagnostic laparoscopy- 21 and exploratory laparotomy- 07) while 16 (29.4%) required therapeutic procedures (emergency- 08; elective- 08).Conclusions: In spite of extensive investigations, many patients of abdominal tuberculosis require surgical management either minimally invasive or otherwise, both for confirmation of diagnosis and for definitive management.

scholarly journals Diagnosis Pattern and Outcome of Adolescents Admitted with Recurrent Abdominal Pain in a Tertiary Care Hospital

2017 ◽  
Vol 41 (1) ◽  
pp. 4-8
Author(s):  
Hossain Sahid Kamrul Alam ◽  
Mohammed Rizwanul Ahsan ◽  
Md Aynal Hoque ◽  
Abm Mahfuz Hassan Al Mamun ◽  
Syed Shafi Ahmed
Keyword(s):  
Abdominal Pain ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Abdominal Tuberculosis ◽  
Recurrent Abdominal Pain ◽  
Care Hospital ◽  
Functional Abdominal Pain ◽  
Management Protocol ◽  
History Of ◽  
The Cost

Background: Abdominal pain is very common among children and adolescents. There are many causes of recurrent abdominal pain in children, but parents may find it surprising that it is very common for there to be no clear cause identified for childhood abdominal pain even though examinations and tests have been done.Objective: This study was carried out to identify the demographic profile, causes and outcomes of adolescents admitted with recurrent abdominal pain.Methods: This Retrospective descriptive study was carried out at the Adolescent Unit of Dhaka Shishu (Children) Hospital during the period from 1st October 2015 to 31st March 2017 among 102 adolescents with history of recurrent abdominal pain after following the inclusion and exclusion criteria. Collected data were statistically analyzed with the use of the Statistical Package for Social Science (SPSS) program version 15.Results: Out of 1080 total 102 (9.44%) adolescents were admitted with recurrent abdominal pain of which majority subjects were male (57%). Urban were 61.76% and rest were rural (38.24%). The specific diagnosis pattern revealed that majority had Functional abdominal pain (44.12%) followed by Urinary tract infection (UTI) (20.59%), Peptic ulcer diseases (13.73%), Gastroesophagial reflux diseases (GERD) (11.76%), Abdominal tuberculosis (5.88%), Pelvic inflammatory diseases (4.90%), Cholecystitis (1.96%) and Abdominal migraine (0.98%).Conclusion: Recurrent abdominal pain is common among adolescents. Functional abdominal pain is the most common cause of recurrent abdominal pain. An uniform management protocol should be developed for proper investigations to minimize the cost and for judicious use of drugs in order to help these adolescents with recurrent abdominal pain.Bangladesh J Child Health 2017; VOL 41 (1) :4-8

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