Experience of laparoscopic management in 100 patients with acute abdomen.

BACKGROUND/AIMS: The decision to operate on a patient with acute abdominal pain comes to the mind of the surgeon if routine investigations fail to identify the cause. A negative laparotomy may have complications, while laparoscopy appears to be a valuable way to improve the accuracy of diagnosis of acute abdominal pain and offers a promising modality of treatment.

METHODOLOGY: The study included 100 patients with provisional diagnosis of acute abdomen after clinical examination and conventional diagnostic aids. All the patients have been subjected to diagnostic laparoscopy.

RESULTS

Eight cases (8%) were managed by laparotomy following diagnosis by laparoscope (disturbed ectopic pregnancy), while 92 cases (92%) were managed laparoscopically which resulted in 81 cases (81%) of successful laparoscopic procedure (31 appendectomies, 19 cholecystectomies, 12 ovarian cyst accident, and others) and 11 cases (11%) were converted to open surgery (4 gallbladder empyema, 2 appendicular mass, 2 intestinal obstruction, and others). Postoperative complications were two cases of wound infection managed conservatively (perforated appendix). The postoperative follow-up for six months was uneventful.

CONCLUSIONS

Laparoscopic management of acute abdomen is a safe and effective method with the advantages of small scar, short hospital stay and early recovery.