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


  • Pradeep Saxena Department of Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India



Ascites, Abdominal tuberculosis, Chronic abdominal pain, Laparoscopy, Nonspecific abdominal pain


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.


Saxena P, Saxena S. The role of laparoscopy in diagnosis of abdominal tuberculosis. Int Surg J 2016;3:1557-63.

Prafull K, Gaur KJBS. Laparoscopy a tool In diagnosis of lower abdominal pain. Indian J Surg. 2004;66(4):216-20.

Krishnan P, Vayoth SO, Dhar P, Surendran S, Ponnambathayil S. Laparoscopy in suspected abdominal tuberculosis is useful as an early diagnostic method. Anz J Surg. 2008;78(11):987-9.

Akeely MH. The impact of elective diagnostic laparoscopy in chronic abdominal disorders. Saudi J Gastroenterol. 2006;12:27-30.

Lin HC, Shiang MW, Chang WH, Chuan SS, Hsin C, Bair MJ. Abdominal tuberculosis in southeastern taiwan: 20 years of experience. J Formos Med Assoc. 2009;108(3):195-201.

Sayed ZK, Verma RA, Madhukar KP, Vaishampayan AR, Kowli MS, Vaja C. Role of diagnostic laparoscopy in chronic abdominal pain. Int J Sci Stud. 2015;3(4):31-5.

Arshad M, Khamiso T, Hussain A. Yield of diagnostic laparoscopy in abdominal tuberculosis: is it worth attempting? Surgical Laparoscopy, Endoscopy Percutaneous Techniques. 2011;21(3):191-3.

Athavale V, Khandalkar S. The role of laparoscopy in chronic abdominal pain. IJSR. 2016;5(4):75-8.

Ermis F, Uvanikoglu A. Has the role of diagnostic laparoscopy in a single gastroenterology unit changed over 20 years? Akademik Gastroenterol Dergisi. 2013;12(1):6-8.

Sanai FM, Bzeizi KI. Systemic review: tuberculous peritonitis-presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther. 2005;22:685-700.

Demir K, Okten A, Kaymakoglu S. Tuberculous peritonitis-reports of 26 cases, detailing diagnostic and therapeutic problems. Eur J Gastroenterol Hepatol. 2001;13:581-5.

Ibrarullah M, Mohan A, Sarkari A, Srinivas M, Mishra A, Sundar TS. Abdominal tuberculosis: diagnosis by laparoscopy and colonoscopy. Trop Gastroenterol. 2002;23(3):150-3

Bhargava DK, Shriniwas, Chopra P, Nijhawan S, Dasarathy S, Kushwaha AK. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol. 1992;87:109-12.

Han CM, Long CL. Diagnostic laparoscopy in ascites of unknown origin. Chang Gung Memorial hospital 20-year experience. Chang Gung Med J. 2008;31:378-83.

Rai S, Thomas WM. Diagnosis of abdominal tuberculosis: the importance of laparoscopy. JR Soc Med. 2003;96:586-8.

Mohamed A, Bhat N, Abukhater M, Riaz M. Role of laparoscopy in diagnosis of abdominal tuberculosis. Internet J Infectious Dis. 2009:8(2):12-5.

Husain M, Sachan PK, Khan S, Lama L, Rehan NK. Role of diagnostic laparoscopy in chronic and recurrent abdominal pain. Tropical Gastroenterol. 2013;34(3):170-3.

Karvande R, Kamble R, Kharade M. A study of role of diagnostic and therapeutic laparoscopy in chronic and recurrent abdominal pain. Int Surg J. 2016;3:1336-40.

Amandeep S, Nar. Role of diagnostic laparoscopy in chronic abdominal conditions with uncertain diagnosis. Nigerian J Surg. 2014;20(2):156-67.






Original Research Articles