Laparoscopy for diagnosis and treatment of acute abdominal pain

Purpose: To evaluate the role of laparoscopy in the diagnosis and treatment of unexplained acute abdominal pain. Patients and Methods: Fifty-six patients with acute abdominal pain (41 wome n, 15 men; median age 27) who attended our hospital between July 1996 and J uly 1999 and in whom a definite diagnosis could not be made by conventional methods underwent diagnostic laparoscopy. Results: The laparoscopic procedure was performed under general anesthesia in 43 patients and local anesthesia in 13 patients. The median duration of laparoscopy was 16 minutes. The sensitivity and specificity of diagnostic l aparoscopy were found to be 98% and 96%, respectively. The most frequent di agnosis was acute appendicitis (38%), Laparoscopic treatment of the surgica l pathology was possible in 36 patients; in seven patients, conversion to l aparotomy was necessary. The median postoperative hospital stay was 1 day i n the diagnostic laparoscopy group. The median treatment cost was lower in the diagnostic laparoscopy group than in the therapeutic laparoscopy or lap arotomy groups. There was no mortality or morbidity in the laparoscopy grou ps. Conclusions: Laparoscopy is an effective method for the diagnosis and treat ment of surgical pathologies in patients in whom the diagnosis cannot be ma de with physical examination and noninvasive methods.