International Surgery Journal | July-September 2016 | Vol 3 | Issue 3 Page 1336
International Surgery Journal
Karvande R et al. Int Surg J. 2016 Aug;3(3):1336-1340
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Research Article
A study of role of diagnostic and therapeutic laparoscopy in chronic and
recurrent abdominal pain
Rajeev Karvande, Ranjeet Kamble*, Manoj Kharade
INTRODUCTION
Population based studies have shown that chronic
abdominal pain is a pervasive problem. Abdominal pain
was the third most common pain complaint of individuals
enrolled in a large health maintenance organization.
Chronic abdominal pain is defined as recurrent
abdominal pain on and off for more than three months
duration. It leads to evident suffering and disability in
patient both physically and psychologically. Chronic
abdominal pain is associated with poor quality of life.
1
ABSTRACT
Background: Chronic abdominal pain is a common complaint of the patients seeking a primary care physician. It
leads to evident suffering and disability, both physically and psychologically and it is associated with poor quality of
life. Many diagnostic and therapeutic procedures have been described in literature, in that laparoscopy is one of the
modalities that could be of benefit in such cases. Hence, the aim of the study was to evaluate the role of diagnostic
and therapeutic laparoscopy in chronic and recurrent idiopathic abdominal and also to assess the epidemiology,
clinical features, diagnostic modalities and management of chronic and recurrent abdominal pain.
Methods: This is a single centre, prospective study done on 63 patients with chronic abdomen pain. The pain in all
patients was of unknown etiology despite all the investigative procedures. All patients were subjected to laparoscopic
evaluation for their conditions. The findings and outcomes of the laparoscopy were recorded and analyzed.
Results: In the present study Out of 63, 26 were male 37 were female showing female preponderance (58.7%) of
patients presenting with chronic and recurrent abdominal pain with mean age of presentation 31.7 years. The majority
of the patients in our study presented with pain in right lower quadrant pain (n=43) followed by pain in periumbilical
region (n=7). Others had pain in other quadrants of abdomen. Only 6 patients had diffuse abdominal pain. In our
study of 63 patients, the most common finding was chronic appendicular pathology, which was present in 56.1%
patients, inflammatory or congenital band of adhesions noted in around 21.2 % patients, abdominal Koch’s was noted
in 19.7%, mesenteric lymphadenopathy noted in around 18.2%, ovarian cyst findings were noted in around 7.6%
patients, 2 patients had Meckel’s diverticulum and 4 had normal findings. 92.08% (n=58) patients had positive
response (Reduction or complete relief of pain) at the end of one month in relation to effectiveness of diagnostic
laparoscopy combined with a therapeutic procedure while 88.88% (n=56) had positive response at the end of two
months.
Conclusions: Laparoscopy is a safe, quick and effective modality of investigation for chronic abdominal pain. Not
only does laparoscopy point to a diagnosis, it has the added advantage that therapeutic intervention can be done at the
same sitting in most cases thus avoiding another hospitalization or another exploration of the abdomen. Diagnostic
laparoscopy has a high diagnostic and therapeutic efficacy.
Keywords: Diagnostic, Therapeutic laparoscopy, Recurrent abdominal pain, Epidemiology
Department of Surgery, LTMMC and LTMGH, Sion, Mumbai, Maharashtra, India
Received: 01 July 2016
Accepted: 15 July 2016
*Correspondence:
Dr. Ranjeet Kamble,
E-mail: drranjeetkamble@yahoo.co.in
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-2902.isj20162616