Role of laparoscopy in acute abdomen

Abstract

Background and aim Admission with an acute abdomen is one of the commonest reasons for emergency surgical admission. The aim of this study was to examine the role of laparoscopy in the management of such cases. Patients and methods A total of 35 patients who presented with acute abdomen in the period between January 2016 and March 2018 were enrolled. Their age was ranged between 10 and 55 years. After history taking and examination, baseline laboratory data were done. All patients were subjected to plain abdominal radiography, abdominal ultrasound, and computed tomography if needed. Under general anesthesia, laparoscopy was performed in all patients in a supine position. Results The mean age of enrolled patients was 33.51±10.54 years. Approximately two-thirds of them were females. Besides the abdominal pain, 80.0% patients had a fever, and more than one-half of them (54.3%) had vomiting. Based on an abdominal ultrasound, one-third of the cases had acute calculous cholecystitis. Approximately half (48.6%) of the cases had unremarkable findings and needed another test to reach a final diagnosis. Based on clinical, laboratory, and radiological data, we reached conclusion in up to 40% of the cases as acute appendicitis and 28.6% as acute cholecystitis, but we could not reach a diagnosis in approximately one-third of the cases. Only 5.7% could not be completed by laparoscopy and were converted to open surgery owing to bleeding. The majority (77.1%) of the cases had no postoperative complications. Conclusion Laparoscopy provided higher diagnostic accuracy and improved quality of life in cases of acute abdomen.