Laparoscopy in management of surgical causes of acute verses chronic pain abdomen in adults visiting tertiary care hospital in Telangana, India
Keywords:Therapeutic laparoscopy, Diagnostic laparoscopy, Acute pain abdomen, Chronic pain abdomen
Background: Pain abdomen accounts for about 14.2% of all emergency hospitalization. Many patients remain undiagnosed even after excluding the common disorders by meticulous investigations. In case of diagnostic uncertainty, laparoscopy may help to avoid unnecessary laparotomy, provide accurate diagnosis. The current study aimed at comparing the role of laparoscopy in management of surgical causes of acute and chronic pain abdomen.
Methods: A prospective study was done in 168 adult patients attending tertiary care hospital, selected by convenience sampling method. After clinical examination and relevant investigation, patients in need of diagnostic and therapeutic laparoscopic management were included in study. Laparoscopic findings and postoperative status of patients, with acute and chronic pain abdomen were compared with relevant statistical tests.
Results: Mean age of patients was 35.8 years. Majority of the patients were females (58.3%). 41.1% and 58.9% patients had acute and chronic pain abdomen, respectively. Though more patients with chronic pain abdomen (58.9%) underwent laparoscopy when compared with acute pain abdomen (41.1%) it was not statistically significant, also post-operative status though found to be better in patients with chronic pain abdomen was not statistically significant.
Conclusions: Though prevalence of laparoscopic intervention and better outcome was found more in patients with chronic abdominal pain in the present study it was not statistically significant.
Mohan V. Sitaram and Simon Paterson Brown. In: William NS, ed. History and examination of the abdomen. Bailey and Love’s Short Practice of Surgery 27th ed. London: CRC press; 2018: 1016-21.
Thakur JK, Kumar R. Epidemiology of acute abdominal pain: a crosssectional study in a tertiary care hospital of Eastern India. Int Surg J. 2019;6(2):345-8.
Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain. Four classifications can guide assessment and management. Geriatrics. 2002;57(3):30-42.
Prasad H, Rodrigues G, Shenoy R. Role of ultrasonography in nontraumatic acute abdomen. Int J Radiol. 2007;5(2):1-4.
MSD Manual Professional Version. Chronic abdominal pain and recurrent abdominal pain, 2020. Available at: https://www.msdmanuals.com/en-in/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/chronic-abdominal-pain-and-recurrent-abdominal-pain. Accessed on 1 March 2021.
Lavu J, Golla S. Clinical profile and management of acute abdomen in a tertiary care hospital. IJSS J Surg. 2020;6(5):10-13.
Husain M, Sachan PK, Khan S, Lama L, Khan RN. Role of diagnostic laparoscopy in chronic and recurrent abdominal pain. Trop Gastroenterol 2014;34(3):170-3.
Nagy AG, James D. Diagnostic laparoscopy. Am J Surg. 1989;157(5):490-3.
Berci G. Elective and emergent laparoscopy. World J Surg. 1993;17(1):8-15.
Easter DW, Cuschieri A, Nathanson LK, Lavelle-Jones M. The utility of diagnostic laparoscopy for abdominal disorders. Audit of 120 patients. Arch Surg. 1992;127(4):379-83.
Rathod A, Agrawal A, Mehera B. Role of laparoscopy in chronic and recurrent abdominal pain-rural area experience. Indian J Surg. 2015;77(3):1018-22.
Tulaskar N, Nichkaode P, Dasgupta S, Choudhary A, Zamad R. Evaluation of role of laparoscopy in chronic abdominal pain. Int J Biol Med Res. 2013;4:3230-3.
Rubbia A, Faryal GA. Role of diagnostic laparoscopy in patients with acute or chronic nonspecific abdominal pain. World J Laparosc Surg. 2015;8:7-12.
Udwadia TE. Diagnostic laparoscopy, laparoscopic surgery in developing countries. BJS. 1997;15-43.
Bellad AP, Murgod AA. Role of diagnostic laparoscopy in chronic abdominal pain with uncertain diagnosis: A 1-year cross-sectional study. World J Laparosc Surg. 2019;12(1):9-14.
Thawait A, Dwivedi S, Bhatt M, Bakhshish K, Mittal A. Role of early laparoscopy in diagnosis of acute abdominal pain. Int J Contemp Med Res. 2017;4(7):1568-74.
Bahram M, Ahmed M. Diagnostic and therapeutic value of diagnostic laparoscopy in patient with chronic abdominal pain. Emerg Med. 2015;5:292.
Rao GN, Suresh BK, Lakshmi KC. Role of diagnostic laparoscopy in cases of acute and chronic abdominal pain. J Evid Based Med Health. 2019;6(42):2729-33.
Subramaniam R. Diagnostic laparoscopy in acute abdominal pain. Int Surg J. 2019;6:1104-7.
Schrenk P, Woisetschlager R, Wayand WU, Rieger R, Sulzbacher H. Diagnostic laparoscopy: a survey of 92 patients. Am J Surg. 1994;168(4):348-51.