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, is challenging to the surgeons. In many patient’s laparotomy is the only alternative.Laparoscopy is defined as the technique in which abdomino-pelvic cavity is visualized through small openings in the wall of abdomen through instruments. In patients with RIF pain, only diagnostic laparoscopy can be considered as the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic

Aim: The Aim of the study is to evaluate 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 laboratorial investigation, coming to surgery OPD of our institute, over a period of 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 undergone investigations for the same.

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

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