Acquisition of Diagnostic Laparoscopy in undiagnosed Right Lower Abdominal Pain Patients.

Abstract

Background: Patients with right lower abdominal pain in whom routine investigations and sonography are negative are challenging to the surgeons. In many patients, laparotomy is the only alternative. Laparoscopy is the technique in which the abdominopelvic cavity is visualized through instruments through tiny openings in the wall of the abdomen. In patients with RIF pain, only diagnostic laparoscopy can be considered the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic.

Aim: The study aims to evaluate the role of laparoscopy in right lower abdominal pain with uncertain diagnosis.

Settings and Design: In this prospective study, patients with right lower abdominal pain with uncertain clinical diagnosis, USG abdomen and laboratory investigation, coming to surgery OPD of our institute over 24 months were considered for Diagnostic Laparoscopy.

Material and Methods: Diagnostic laparoscopy was performed in 174 patients. These patients presented with right lower abdominal pain and underwent investigations for the same.

Results: Laparoscopy yielded positive findings in 170 (97.7%) of these patients. Appendicitis, gynecological pathology, and abdominal tuberculosis were the significant findings. Therapeutic procedures were performed on 165 patients (laparoscopically 158). There was only one complication in this series: the patient developed a surgical site infection on postoperative day 2. So, the patients who had remained undiagnosed were diagnosed and given appropriate treatment.

Conclusion: This study establishes the role of Diagnostic Laparoscopy as a safe and one of the most prolific investigative tools in undiagnosed right lower abdominal pain.