A PROSPECTIVE STUDY TO DEFINE THE ROLE OF DIAGNOSTIC LAPAROSCOPY IN EVALUATING RIGHT LOWER QUADRANT PAIN
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 61
Abstract
BACKGROUND Diagnostic laparoscopy is of tremendous help in a patient with uncertain abdominal pathology. The appropriate implementation of diagnostic laparoscopy often helps to avoid expensive diagnostic studies and more importantly unnecessary laparotomy. METHODS Data was collected prospectively from September 2013 to November 2015 in patients with right lower abdominal pain admitted to the Emergency Department and subsequently transferred to the Department of General Surgery and undergone diagnostic laparoscopy were evaluated. RESULTS In the study, it was noticed that (87.5%) patients among 342 patients had an advantage of undergoing diagnostic laparoscopy without the need for other diagnostic tests like CECT and got the extended definitive therapeutic or ancillary procedure. Laparoscopic finding of appendicitis was noted in 55 patients among which 84% appendicitis alone. The rest 16% had coexisting finding like adhesion, adnexitis, and mesenteric lymphadenitis. Out of patients with inflamed appendix, 32 were females, 24 were in the age group of 18 to 25. Of the female patients, 3 patients were postmenopausal. Females were commonly affected by adhesions. Only, 15% of female patients had gynaecological pathology. Only in 6 patients, diagnostic laparoscopy revealed normal appendix. 12 patients had adhesions involving mesentery and bowel. Of these 6 patients had associated findings, only 5% who underwent diagnostic laparoscopy had rare findings like Meckel’s diverticulitis, mesenteric panniculitis, etc. Diagnostic laparoscopy has become the standard procedure for RLQP for this reasons. Laparoscopy is ideally suited for use in diagnosis and potentially treating patients with unexplained RLQ Pain. Several studies have reported the safety and efficacy and also documented good results. CONCLUSION Laparoscopy provided its diagnostic benefit in patients who presented with right lower abdominal pain and even better results in women in child bearing age. It is a very valuable to arrive a proper diagnosis and plan treatment. Women of childbearing age get the added advantage of tiny scars and rules out other gynaec pathology
Authors and Affiliations
Ramula , Arun , Karthik , Ashwini , Palanisamy
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