الفهرس 
Investigation of acute abdomenOnly 14 pages are availabe for public view
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Abstract
The present study was carried out to evaluate laparoscopy as a diagnostic and therapeutic tool in management of acute abdomen.
Acute abdominal pain can present a diagnostic dilemma. It accounts for 13-40% of all emergency surgical admission. Clinical examination often fails to yield a diagnosis, particularly when the symptoms and signs are compounded by extremes of age or obesity. This problem is more common, in but not exclusive to, female patients. Blood investigations in most scenarios; simply indicate the presence of an inflammatory process. Radiology may suggest a diagnosis, but both radiography and ultrasound have a false-negative rate.
Women of child-bearing age present a particular problem in the diagnosis of acute lower abdominal pain. Gynecological conditions may present with signs and symptoms that are indistinguishable from acute appendicitis, and traditionally diagnostic laparoscopy has been favored in this group, as it provides greater visualization of other intraabdominal organs and less postoperative adhesions, particularly when the additional advantages of therapeutic laparoscopy are considered.
Early diagnostic laparoscopy and treatment result in accurate, prompt and efficient management of acute abdominal pain. This technique reduces the rate of unnecessary laparotomy, and right iliac fossa incisions and increases the diagnostic accuracy in these patients. This treatment method is feasible where facilities are available to accommodate the workload and there are practitioners with the requisite expertise.
We appreciate that not all institutions have the facilities or scheduling to submit all patients with acute abdominal pain to diagnostic laparoscopy and that there may be fears that this policy would increase costs. However, we think that there are significant patient benefits in making an early diagnosis and initiating treatment. It is also our impression that the costs are balanced by the shorter hospital stay, and the reduction in complications rate. In addition the benefits in terms of laparoscopic training for junior staff have been so significant.
Early interventional laparoscopy is recommended as a diagnostic and therapeutic tool in acute abdominal pain, irrespective of the patient’s age or sex, to take advantage of the proven benefits of minimal-access surgery and to ensure that no diagnosis is missed.