European Journal of Molecular & Clinical Medicine

Abstract

Background:Chronic abdominal pain is defined as a condition in which the patient
complains of a long term persisting pain that lasts for several months (>6 months) since
the irritation of pain. Chronic abdominal pain has a variety of causes which requires
prompt treatment, but all of them do not require exploration. Chronic Abdominal Pain
(CAP) is a common complaint of patients seeking a primary care physician, it is a
leading reason for referral to a gastroenterologist and the 4th frequent chronic pain
syndrome in the general population, it represent about 13% of all surgical
admissions.Aims and Objectives: We aim to evaluate the diagnostic and therapeutic
efficacy of laparoscopy in the management of such patients in this prospective study.
Materials and Methods: Thirty five patients with chronic pain abdomen were included
in this study. The pain in all these patients was either of unclear etiology or not
responding to the treatment given after clinical assessment and lasting for more than 3
months duration. Pain of shorter duration and patients less than 14 years of age were
excluded from the study. All patients were subjected to diagnostic laparoscopy and
procedure. The results were tabulated and analyzed.
Results: Females were more affected by this condition and the most common site of pain
being the peri -umbilical region. A definitive diagnosis was made per operatively in 29
patients (82.85%) while in the remaining 6 (17.14%), no obvious pathology was
detected. The most common findings in our study was post-operative adhesions (40%),
followed by recurrent appendicitis (1%), Carcinoma (7.5 %) , Mesenteric
lymphadenopathy and Tuberculosis (2.5% each). Pain assessment done at 1
monthfollow up showed pain relief in 85.7% and 3 month follow up showed pain relief
in 70% of patients.
Conclusion: Post operative adhesions form a majority of cause for causing chronic pain
abdomen. Diagnostic laparoscopy is a safe and effective modality for the diagnostic and
therapeutic management of such patients.