Abstract

Dr. Saba Maryam*, Dr. Lariab Fatima and Dr. Smavia Aslam

ABSTRACT

Background: Acute abdomen is a surgical emergency and sometimes portrays a challenge as its cause remains unexplained unless explored. Recently, trend of diagnostic laparoscopy in acute abdominal conditions is growing among surgeons due to its benefits of establishing diagnosis and provision of therapy with minimal invasive approach. Objective: To assess the diagnostic and therapeutic utility of laparoscopic surgery in unexplained acute abdominal conditions. Methodology: Fifty three patients, from September 2018 to June 2019, with unexplained acute abdominal conditions on clinical and radiological assessments were subjected to diagnostic laparoscopy. Therapeutic laparoscopic surgery was offered to all diagnosed cases. Resected specimens were directed for histopathological analysis to confirm diagnosis. All patients were followed up to 3 months. The data was entered and analysis by using SPSS version 20. Results: Accurate diagnosis was established successfully in all patients. The outcome of diagnostic laparoscopy was: uncomplicated acute appendicitis in 31(58.49%) patients, complicated acute appendicitis in 5(9.43%) patients, acute cholecystitis in 1(1.88%) patients, pancreatic necrosis in 1(1.88%) patients, mesenteric adenitis in 2(3.77%) patients, caecal mass in 2(3.77%) patients, dual pathologies in 5(9.43%) patients, and gynaecological emergencies in 6(11.32%) patients. We did not need to convert to open surgery for diagnostic or therapeutic purpose in any case. No significant intraoperative and postoperative complications were observed. All patients were discharged within 2 days after surgery except three cases. There was no mortality. Conclusion: Our initial experience showed that diagnostic laparoscopy in acute abdomen is useful in establishing diagnosis, safe to perform and achieves therapeutic goals in almost all patients.