ROLE OF LAPAROSCOPY IN THE DIAGNOSIS AND MANAGEMENT OF NONSPECIFIC ABDOMINAL PAIN
Authors: Arifuddin Qazi , Muntassir Khan Noman , Khan Mohd Omar 
Published: February 2024

Introduction: Acute nonspecic abdominal pain(NSAP)is generally dened as acute abdominal pain of under 7 days duration, and ,for which there is
no diagnosis after clinical examination and baseline investigations. Aims and Objectives: To Study Role of Laparoscopy in the Diagnosis and
management of Nonspecic Abdominal pain. Methodology: This was prospective study during 2 years period i.e. December 2012 to November
2014.All patients admitted to a tertiary care centersurgery ward through outpatients department or casualty during study period were included in the
study group. Patients needing exploratory laparotomy for nonspecic acute abdomen i.e. pain of less than 7 days duration where other clinical
symptoms and investigations are not conclusive were included into study while. Morbidity included SSI (surgical site infection), persistent postoperative pain and shoulder pain. Patients were followed for 6 months post discharge for recurrence of pain and readmission. Result: Out of total 397
patientsscreened 50werewithNonspecic acute abdomen pain (NSAP). 38% patientsweremaleswhile 62%patientswere female.Themajority ofthe
patients were in the age group of 21-30 and 31-40 i.e. 34%. Based on the ndings of diagnostic laparoscopy Group: A- Pathology diagnosed -
33(66.00%), Group :B- No pathology detected-8(16.00); Group C- Insufcient information -9(18.00). In group A patients most common i.e.13
patients had appendicitis(inamed, perforated or gangrenous).In groupBpatients no pathology was detected on diagnostic laparoscopy.In groupsC
patients most common i.e. 9 patients, diagnostic laparoscopy was found to be insufcient to conclude any pathology. Out of 50 patients, diagnostic
laparoscopy could help 41 patients. In 33 patients particular pathology wasidentied. 13 patients had diagnostic laparoscopy followed by therapeutic
laparoscopic procedure,including, 9 laparoscopic appendectomies, 2 ovarian cystectomies and in 2 patients adhesive bandswere cutrelieving the acute
symptoms. In group B patients diagnostic laparoscopy was negative the need of urgent surgical measure. unexpected appendicitis found in Group A
were 13 (26%); No patientsin GroupB(0%) and in GroupC were 3(6%) patients. NoMorbidity found inCategory 1 andCategory 2 patients; and in
Category 3 - 2/10 andCategory 4 were 4/12. Category 1 and 2 patients were discharged over mean duration of around 3 days.Category 3 patients had
mean hospitalstay of 5 days. Category 4 patients had 10 days of mean hospitalstay. Mean hospitalstay of laparoscopy only group i.e. category 1 and 2
togetheris 2.75 days(SD=±0.7).Conclusion: Diagnostic laparoscopy effectively establishes a diagnosis, can be therapeutic and causeslessmorbidity
andmight change the further course ofmanagement to amore limited approach or conservative line ofmanagement and help in avoiding unnecessary
non-therapeutic laparotomies, a normal laparoscopy may allow the surgeon to discharge patients who are stillsymptomatic. Condent that there is no
requirement of for laparotomy. Incorporation of a laparoscopy may improve the management of emergency admissions and , may also; have cost
benets byrenderinghospitalstayandre admissionrates.