DIAGNOSTIC LAPAROSCOPY IN WOMEN WITH ACUTE ABDOMINAL-PAIN

Nineteen women with acute lower abdominal pain of uncertain etiology u nderwent diagnostic laparoscopy during a 2-year period from August 199 1 to August 1993 and were retrospectively reviewed. All patients, aged 12 to 44 years, were premenopausal. Laparoscopy provided definitive d iagnosis in air 19 patients. Laparoscopic findings included appendicit is (11 cases), pelvic inflammatory disease (five cases), significant o varian cysts (two cases), and ectopic pregnancy (one case). Successful laparoscopic procedures included appendectomy (five cases), and salpi ngo-oophorectomy (one case). Five patients required only diagnostic la paroscopy. Eight patients required conversion to an open procedure bec ause of anatomical considerations (six cases) or equipment failure (tw o cases). Median operative time was 71 min, and median postoperative h ospital stay was 2 days. Most diagnostic procedures were performed on the same day as admission, resulting in a median hospital stay of 3 da ys. Diagnostic laparoscopy performed in premenopausal female patients with acute lower abdominal pain of unknown etiology provides diagnosti c accuracy as well as therapeutic capabilities and prevents unnecessar y laparotomy.