Objectives. Exploratory laparotomy offers the greatest diagnostic accu
racy of intra-abdominal pathologic processes, but can be associated wi
th significant morbidity. Laparoscopy provides diagnostic capabilities
equivalent to that of open exploration, but with potentially less mor
bidity. We present 3 cases in which laparoscopy was used to diagnose a
nd manage urologic patients with an acute abdomen in a postoperative p
eriod. Methods. Three patients underwent laparoscopy between 1 and 14
days postoperatively for an acute abdomen (fever, elevated white blood
cell count, and peritoneal signs). The initial procedures included a
pubovaginal sling repair with fascia lata, endoscopic placement of a p
ercutaneous gastrostomy tube, and a laparoscopic ureterolithotomy for
a distal stone. Results. In each of the 3 patients laparoscopy reveale
d misplacement or malfunction of a previously placed tube. In all case
s, the patient was managed laparoscopically without the need for lapar
otomy. Conclusions. These cases demonstrate the feasibility of laparos
copy to provide diagnostic and therapeutic solutions to postoperative
urologic patients presenting with an acute abdomen. (C) 1998, Elsevier
Science Inc. All rights reserved.