The Outcome of Elective Diagnostic Laparoscopy in Diagnosing Chronic Abdominal Pain-in a Tertiary Health Care Centre

Dr. Sourav Shubham, Dr. Biswa Ranjan Mohapatra, Dr. Yagnadutta Rath

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. Aims and Objectives: We aim to evaluate the diagnostic and therapeutic efficacy of laparoscopy in the management of such patients in this prospective study. Materials and methods: Thirty five 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 14 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 peri -umbilical region. A definitive diagnosis was made per operatively in 29 patients (82.85 %) while in the remaining 6 (17.14 %), no obvious pathology was detected. The most common findings in our study was post-operative adhesions (51.42 %), followed by recurrent appendicitis (14.28 %), Carcinoma (5.71 %), Mesenteric lymphadenopathy and Tuberculosis (2.85 % each). Pain assessment done at 1 month follow up showed pain relief in 85.7 % and 3 month follow up showed pain relief in 70 % of patients. Conclusion: Post operative adhesions 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.

Keywords: Diagnostic laparoscopy, chronic pain abdomen, post operative adhesions, diagnostic efficacy