DIAGNOSTIC LAPAROSCOPY FOR CHRONIC RIGHT ILIAC FOSSA PAIN - A PILOT-STUDY

Background: The aim of this study was to determine the value of diagno stic laparoscopy in patients with chronic right iliac fossa pain. Meth ods: A retrospective study at Echuca Hospital involving case-note revi ew and telephone questionnaire of patients who had undergone diagnosti c laparoscopy for chronic right iliac fossa pain at least 12 months ea rlier (September 1992 to August 1995) was carried out. Results: Forty- one cases were identified and followed up 12-40 months postoperatively (median 21 months). Eleven cases had positive findings at laparoscopy , of whom eight obtained lasting relief after treatment. Of the remain ing 30 patients 17 had a normal-looking appendix removed and 12 were c ured; these were younger patients with episodic symptoms and localized signs. Of eight patients who had adhesions divided, four with adhesio ns beneath old scars obtained relief. Altogether 32 of the 41 patients considered the laparoscopy worthwhile even though in some cases it di d not relieve their chronic pain. Conclusions: Diagnostic laparoscopy is worthwhile for patients with chronic right iliac fossa pain. Concur rent appendicectomy should be considered in young patients with episod ic, well-localized symptoms associated with systemic malaise while adh esiolysis may be beneficial for viscero-parietal adhesions beneath abd ominal wall scars.