Abstract
Background: Chronic abdominal pain is a common condition encountered by many surgeons in their clinic every day. Despite of availability of different tests in maximum cases the reason behind the pain remains unknown. Diagnostic Laparoscopy is a safe technique that can identify the cause of the pain without using any invasive method. In the present study, the use of diagnostic laparoscopy in the diagnosis and management of chronic and recurrent abdominal pain of unknown origin was investigated.
 Material and Methods: All the patients who visited the outpatient department with chronic abdominal pain were included in this study. All the demographic parameters were included and after careful investigation diagnostic laparoscopy were conducted in all these patients. The postoperative outcomes were also recorded in all the patients.
 Result: Total of 51 patients was included in this study. Among these patients 23 patients were male and 28 patients were female. Maximum of the patients were in the 31-40 years of age group. The most common pathology for chronic abdominal pain was chronic appendicitis (n=9, 18%) followed by Koch's abdomen and adhesions (n=8, 16%). There were 4 cases of Carcinoma of the gall bladder and 3 cases of metastatic disease with dissemination in the peritoneal cavity and ascitis. 3 cases of liver cirrhosis and 3 cases of endometriosis were also detected. 2 cases of ovarian cysts which were missed by USG were detected correctly by laparoscopy. There were two unusual cases, one of chronic ectopic pregnancy and another of Crohn's disease. All the above findings were confirmed by direct visualizing (86%), or by biopsy (74%) or by fluid analysis. There were no long term complications in our study.
 Conclusion: The present study concluded that laparoscopy is a safe and effective method for diagnosis of chronic abdominal pain.
 Keywords: Chronic abdominal pain, diagnostic laparoscopy, recurrent abdominal pain
Highlights
Abdominal pain is one of the common presentations in surgical practices
Studies have shown that in approximately 40% of the cases the etiology behind the recurrent abdominal pain remains undiagnosed [2]. These undiagnosed abdominal pain cases are often referred to as the unexplained chronic abdominal pain or commonly as UCAP [3]. It is a great challenge for a physician to detect accurately the correct etiology of Diagnostic Laparoscopy is a safe technique that can identify the cause of the pain without using any invasive method
In another study conducted by Krishnan et al (2008) it was shown that in patients with abdominal tuberculosis without any other complication, diagnostic laparoscopy can prove to be a useful technique that aids to establish a histological diagnosis [11]
Summary
Abdominal pain is one of the common presentations in surgical practices. It is a commonly found complication faced by many of the surgeons in their clinic. In a maximum of the patients with chronic and recurrent abdominal pain correctly diagnostic laparoscopy can identify the etiology and can help in improvement of the condition. Studies have shown that in approximately 40% of the cases the etiology behind the recurrent abdominal pain remains undiagnosed [2]. These undiagnosed abdominal pain cases are often referred to as the unexplained chronic abdominal pain or commonly as UCAP [3] It is a great challenge for a physician to detect accurately the correct etiology of Diagnostic Laparoscopy is a safe technique that can identify the cause of the pain without using any invasive method. The use of diagnostic laparoscopy in the diagnosis and management of chronic and recurrent abdominal pain of unknown origin was investigated
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