Management of chronic abdominal pain using diagnostic laparoscopy: a clinical study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 5443-5449
AbstractBackground: Chronic abdominal pain is a common disorder both in general practice and in hospitals. Although patients with this type of pain may have undergone numerous diagnostic workups, including surgery, their pain remains a challenge to all known diagnostic and treatment methods.
Aim: the aim of this study to evaluate the role of diagnostic laparoscopy in the management of chronic abdominal pain in Bihar Region.
Material and methods: This Prospective observational study was done in the Department of Surgery, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India, for 8 months. All 100 patients with chronic abdominal pain of 6 months or more duration, with normal or inconclusive investigations coming to surgical OPD and patients of age group 18 to 70 years were included.
Results: Majority of the patients (38%) were in the age group of 20-30 years. The mean age of the patients was 35.88±12.77 years. 64 (64%) patients of the study group were female while 36 (36%) patients were male. The most common symptoms were pain (100%) followed by vomiting (47%), fever (30%), abdominal distension (17%) and bowel symptoms (10%). 12 (12%) patients had pain in abdomen for 3-12 months while 39 (39%) and 19 (19%) patients had pain in abdomen for 12-18 months and 18-36 months respectively. 30 (30%) patients had abdominal pain for >36 months. The most common laparoscopy findings were appendicitis (30%) followed by Koch’s abdomen (25%), adhesions (25%), sub-acute intestinal obstruction (SAIO) (7%), chronic cholecystitis (5%) and hernia (2%) and (6%) patients had normal findings. All 30 patients diagnosed with appendicitis underwent laparoscopic appendectomy. In all 25 patients diagnosed with Koch’s abdomen, laparoscopic biopsy was performed and positive patients were treated with anti- tubercular drugs by standard protocols. All patients with adhesions were treated by adhesiolysis.
Conclusion: Laparoscopy has an effective diagnostic role in evaluating patients with chronic abdominal pain, in whom conventional methods of investigations have failed to elicit a certain cause. The therapeutic value of diagnostic laparoscopy is also accepted, well appreciated, and it cannot be underestimated.
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