Role of Diagnostic Laparoscopy in Chronic Abdominal Pain with Uncertain Diagnosis - A One Year Cross Sectional Study at KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi

Abstract

ABSTRACT Background and objectives Diagnostic laparoscopy, is a minimally invasive procedure that could potentially be diagnostic and also therapeutic for chronic undiagnosed abdominal pain. This study was aimed to evaluate the causes of chronic abdominal pain in undiagnosed patient on biochemical and radiological investigations and to study the outcome in terms of pain relief in such patients. Methodology This one year cross-sectional study was carried out in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Research Center, Belagavi. A total of 55 patients presenting with chronic abdominal pain (≥8 weeks) with uncertain diagnosis from January 2016 to December 2016 were studied. Results Most of the patients (65.45%) were females, and the male to female ratio was 1:1.89. The most common age group was 18 to 30 years (38.18%) and the mean age was 37.67±14.45 years. Most of the patients (65.45%) had duration of pain between 8 to 12 weeks and mean duration of pain was 10.80±2.78 weeks. Fever was present in 41.82% of the patients. Most of the women reported history of previous LSCS (5.45%) and 3.64% of the patients had history of hypertension. The most common surgical finding was adhesions (30.91%) followed by inflamed appendix (29.09%) and most common surgical procedure performed was adhesiolysis (30.91%) followed by appendicectomy (29.09%). The mean VAS gradually reduced from 3.05±1.88 on Day 15 to 1.22±1.54 on Day 30, 0.47±1.02 on Day 45 and 0.25±0.78 on Day 60 This reduction was statistically significant (p<0.001). Conclusion and interpretation Adhesions and inflamed appendix are important causes of chronic abdominal pain. Furthermore Elective diagnostic laparoscopy in selected patients, offers excellent pain relief and an effective diagnostic modality in the management of patients with chronic abdominal pain.