THE IMPACT OF ELECTIVE DIAGNOSTIC LAPAROSCOPY IN DIAGNOSING CHRONIC ABDOMINAL PAIN

Abstract

Background: Chronic idiopathic pain syndromes are amongst the most challenging and demanding conditions to treat across the whole age spectrum. Despite these patients having undergone numerous diagnostic work ups, their pain remains a challenge to all known diagnostic and treatment methods. Objectives Of The Study: To study the advantages of diagnostic laparoscopy in identifying the etiology of undiagnosed chronic abdominal pain. Materials And Methods: Study Centre: Institute of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. October 2019 to October 2020. Single-center cross-sectionalDuration Of Study: Study Design: study. All the patients who came to general surgery OPD during my one-year study period 35 {n = Z2 1-α/2 P (1-P)Sample Size: /e2 P=3% e= 5% Z=1.96}. All cases of undiagnosed (by conventional methods and investigations such asInclusion Criteria: detailed history, clinical examination, blood counts, urine examination, USG abdomen, Plain x ray abdomen) chronic abdominal pain>3months duration of both sex. All cases of undiagnosed chronic abdominal pain in patients >14years of age. Cases of clinically diagnosed chronic abdominal pain of >3 months duration not responding to the treatment given. Exclusion Criteria: Results:Persons suffering from any kind of cognitive dysfunction are excluded from the study. All 35 patients underwent Diagnostic Laparoscopy under General anaesthesia after all the conventional investigations did not yield any diagnosis. 35 patients in the age group of 15 – 69 years were involved in the study with the average age of presentation being 35 years. 66% of the study population were females. The most common nding at laparoscopy in our study was postoperative adhesions (51.42%). It was followed by patients who had a normal abdominal nding at laparoscopy (17.14 %) and recurrent appendicitis in 14.28 %. The average duration of hospital stay being 5.5 days. Therapeutic intervention done at the time of diagnosis relieved 70% of patients of their pain at the end of three months. DiagnosticInterpretation And Conclusion: laparoscopy has an effective diagnostic accuracy and therapeutic efcacy in the management of patients who present to us with chronic abdominal pain especially in whom conventional methods of investigations have failed to elicit a cause for the pain. Ability to pin point a cause for the abdominal pain or exclude a more major cause for pain not only avoids further investigations but also plays a signicant role in alleviating the fears in the minds of the patients. Laparoscopy prevents unnecessary laparotomy in a signicant number of cases. Diagnostic laparoscopy has a denitive role in the management of patients with chronic pain abdomen and should be an important investigative tool in the armamentarium of all practicing surgeons.