Abstract
Background: Diagnostic Laparoscopy provides us with good view of whole peritoneal cavity there by clinching diagnosis. In General population Appendicular pathology is the leading etiology of non specific abdominal pain, it is about 33%, followed by adhesion 23%,positive outcome in 1 month follow up period is 80%,in 3 months follow up period 90% patients got complete relief.
Patients and Methods: Clinical material for this study was obtained from 50 patients with abdominal pain for three months or more where other clinical symptoms and investigations are not conclusive, attending the Out Patient Department and admitted to Rajah Muthiah Medical College and Hospital, willing for diagnostic laparoscopy. The overall efficacy and outcome of this work includes finding the etiology of Non specific abdominal pain, thereby making a definite diagnosis and to assess the response to treatment in relieving pain after three months.
Results: Appendicular pathology is the leading etiology of Non specific abdominal pain. Diagnostic laparoscopy help us to initiate appropriate treatment in this difficult patient group and positive outcome of pain relief (relief/reduction of pain after diagnostic laparoscopy) was observed in 90% of patients.
Conclusion: Diagnostic laparoscopy is a safe, relatively cost-effective and efficient method for finding out the etiology of chronic abdominal pain and to provide specific interventions.
Keywords: Chronic abdominal pain, Adhesions, Biopsy, Hernia, Diagnostic laparoscopy, Pain relief.
References
- Camilleri M. Management of patients with chronic abdominal pain inclinical practice. Neurogastroenterol Motil 2006;18:499-506.
- Townsend CO, Sletten CD, Bruce BK, Rome JD, Luedtke CA, Hodgson JE. Physical and emotional functioning of adult patients with chronic abdominal pain: Comparison with patients with chronic back pain. J Pain 2005;6:75-83.
- McGarrity TJ, Peters DJ, Thompson C, McGarrity SJ. Outcome ofpatients with chronic abdominal pain referred to chronic pain clinic. Am JGastroenterol 2000;95:1812-6.
- Paajanen H, Julkunen K, Waris H. Laparoscopy in chronic abdominal pain: A prospective nonrandomized long-term follow-up study. J ClinGastroenterol 2005;39:110-4.
- Ferrell BR. The impact of pain on quality of life. A decade of research. NursClin North Am 1995;30:609-24.
- Magni G, Rossi MR, Rigatti-Luchini S, Merskey H. Chronic abdominalpain and depression. Epidemiologic fi ndings in the United States. Hispanic health and nutrition examination survey. Pain 1992;49:77-85.
- Peters AA, Van den Tillaart SA. The diffi cult patient in gastroenterology: Chronic pelvic pain, adhesions, and sub occlusive episodes.Best Pract Res Clin Gastroenterol 2007;21:445-63.
- van Goor H. Consequences and complications of peritoneal adhesions. Colorectal Dis 2007;9:25-34.
- Arya PK, Gaur KJ. Laparoscopy: A tool in the diagnosis of lower abdominal pain. Indian J Surg 2004;66:216-20.
- Lindsetmo RO, Stulberg J. Chronic abdominal wall pain – A diagnostic challenge for the surgeon. Am J Surg 2009;198:129-34.
- Costanza CD, Longstreth GF, Liu AL. Chronic abdominal wall pain: Clinical features, health care costs, and long-term outcome. Clin Gastroenterol Hepatol 2004;2:395-9.
- Galili O, Shaoul R, Mogilner J. Treatment of chronic recurrent abdominal pain: Laparoscopy or hypnosis? J Laparoendosc Adv Surg Tech A2009;19:93-6.
- Salky BA, Edye MB. The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes. Surg Endosc 1998;12:911-4.
- Klingensmith ME, Soybel DI, Brooks DC. Laparoscopy for chronic abdominal pain. Surg Endosc 1996;10:1085-7.
- Mueller MD, Tschudi J, Herrmann U, Klaiber C. An evaluation of laparoscopic adhesiolysis in patients with chronic abdominal pain. Surg Endosc 1995;9:802-4.
- Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain. Surgery 2003;134:549-52.
- Ikard RW. There is no current indication for laparoscopic adhesiolysis to treat abdominal pain. South Med J 1992;85:939-40.
- Swank DJ, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ, et al. Laparoscopic adhesiolysis in patients with chronic abdominal pain: A blinded randomised controlled multi-centre trial. Lancet2003;361:1247-51.
- Yousaf M, Hosuy MA. Small bowel obstruction after laparoscopic inguinalhernia repair. J Coll Physicians Surg Pak 2001;11:721-2.
- Graham A, Henley C, Mobley J. Laparoscopic evaluation of acuteabdo-minal pain. J Laparoendosc Surg 1991;1:165-8.
- Marana, R.; Paielli, FV.; Muzii, L. and Mancusol, J : the role of laparoscopy in evaluation of chronic abdominal pain. Minerva Gyneco. 1993; Jun 45(6): 281– 6;
- V & Krolikowski Gowri, A.: Chronic pelvic pain. Laparoscopic and 70
- Di Lorenzo, N.; Coscarella, G.; Lirosi, F.; Faraci, L. and Rossi,p.: Impact of laparoscopic surgery in the treatment of chroic abdominal pain sysdrome. Chir tal. 2002;54(34): 367-78
- Mahawar, K.K.: Laparoscopic adhesiolysis in patients with chronic abdominal pain. Lancet(England). 2003; 361 (9376)
- Swank, D.J.; Van Erpo, W.F.; Repelaer, O.J.; Hop, W.C. and Bonjer, H.J.: A prospective analysis of predictive factors on the results of laparoscopic adhesiolysis in patients with chronic abdominal pain. Surg Laparosc Endosc.2003; 13(2): 88-94.
- Gouda M El-laddan,Emad N Hokkam The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain. J Min access Surg 2010; 6:95-9.
Corresponding Author
Dr P.Vinoth
Post Graduate, Department of General Surgery, Rajah Muthiah Medical College and Hospital, Chidambaram, Cuddalore, Tamil Nadu, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.163
