Role and Efficacy of Diagnostic Laparoscopy Inchronic Abdominal Pain

Abstract

Background: Chronic idiopathic pain syndromes are amongst the most challenging and demanding conditions to treat across the whole age spectrum. Despite these patients having undergone numerous diagnostic work ups, their pain remains a challenge to all known diagnostic and treatment methods.Objectives: To study the efficacy of diagnostic laparoscopy in identifying the etiology of undiagnosed chronic abdominal pain.Materials and methods: Thirty two patients with chronic pain abdomen were included in this study. The pain in all these patients was either of unclear etiology or not responding to the treatment given after clinical assessment and lasting for more than 3 months duration. Pain of shorter duration and patients less than 15 years of age were excluded from the study. All patients were subjected to diagnostic laparoscopy and procedure. The results were tabulated and analyzed.Results: Females were more affected by this condition and the most common site of pain being the periumbilical region. A definitive diagnosis was made per operatively in 28 patients (87.50%) while in the remaining four (12.50%), no obvious pathology was detected. The most common findings in our study was recurrent appendictis (62.5%), followed by post operative adhesions (12.5%), gall stones(6.25%) ,tubo ovarian pathology (3.12%) and abdominal TB (3.12%). Pain assessment done at 1 month follow up showed pain relief in 84.6% and 3 month follow up showed pain relief in 87.5% of patients.Conclusion: Recurrent appendicitis form a majority of cause for causing chronic pain abdomen.Diagnostic laparoscopy is a safe and effective modality for the diagnostic and therapeutic management of such patients.