Role of Elective Laparoscopic Appendicectomy for Chronic Right Lower Quadrant Pain

Abstract

Chronic right lower quadrant pain is a common clinical entity and continues to remain a diagnostic and therapeutic problem. Laparoscopy is changing the view regarding exploration in patients with chronic right lower quadrant pain. Of recent, chronic or recurrent right lower quadrant pain is an entity that has generated much interest, hence this study has been undertaken. To study the role of elective laparoscopic appendicectomy for chronic or recurrent right lower quadrant pain. To study the relationship between clinical improvement and histopathological findings of removed appendix. Forty three cases of chronic right lower quadrant pain, who met the inclusion criteria, were included in the clinical study. Three cases were excluded during initial diagnostic laparoscopy because of ovarian cyst. Laparoscopic appendicectomy was performed in 40 cases. In our study amongst 40 (100%) patients, 36(90%) patients were relieved of pain completely. Only 4(10%) patients continued to have persistent right lower quadrant pain. Duration of follow up was 6months. Postoperative pain scores favour appendicectomy (p < 0.005). There was no association between postoperative pain scores and histopathology findings. There was no mortality in our study. Persistent or recurrent right lower quadrant pain can be treated successfully by elective laparoscopic appendicectomy in properly selected cases. Laparoscopic appendectomy is a feasible and safe procedure. Histopathology of the removed appendix does not contribute to the diagnosis.