A Study on Role of Diagnosticlaparoscopy in Evaluation of Chronic Lower Abdominal Pain

BACKGROUND: In our surgical practice, we often encounter patients with undiagnosed lower abdominal pain who even after careful evaluation with sophisticated investigations remain undiagnosed. These group of patients pose a major challenge to the diagnostic capabilities of the surgeon. About 13% of patients remains undiagnosed even after battery of investigations. AIMS AND OBJECTIVES: To assess the benefit of using laparoscopy as a diagnostic tool in patients with undiagnosed chronic abdominal pain. To find various causes leading to chronic abdominal pain by diagnostic laparoscopy. MATERIALS AND METHODS: In this observational study, 85 patients are included. Patients who were not diagnosed by clinical diagnosis and imaging investigations such as ultrasonography and computed tomography are included in this study. All the quadrants of the abdomen are examined in a sequential manner. Pathologies identified during the procedure is documented. Therapeutic intervention if possible, is done according to the observed diagnosis. RESULTS: In this study, it was observed that 81 out of 85 patients (95%) were diagnosed. Sub-acute appendicitis (43.5%), adhesions (24.8%), peritoneal tubercles (9.5%), normal study (4.7%), adnexitis (2.3%), hydrosalphinx (4.7%), mesenteric adenopathy (2.3%), mesenteric panniculitis (2.3%), ileocecal tuberculosis (1.2%) ovarian cyst(1.2%) and endometriosis (2.3%). Patients with sub-acute appendicitis and adhesions underwent laparoscopic appendectomy and laparoscopic adhesiolysis respectively. CONCLUSION: Diagnostic laparoscopy is an effective tool which can be used to diagnose and treat the patients with chronic abdominal pain who remain undiagnosed after clinical examination and imaging modalities.