World Journal of Laparoscopic Surgery

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VOLUME 13 , ISSUE 1 ( January-April, 2020 ) > List of Articles

LETTER TO THE EDITOR

Laparoscopy: A See- and -treat Modality for Lower Abdominal Pain in Females

Amina Kuraishy, Noor Afshan Sabzposh, Afzal Anees

Keywords : Adhesiolysis, Laparoscopic, Ultrasound

Citation Information : Kuraishy A, Sabzposh NA, Anees A. Laparoscopy: A See- and -treat Modality for Lower Abdominal Pain in Females. World J Lap Surg 2020; 13 (1):51-54.

DOI: 10.5005/jp-journals-10033-1389

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: In females, lower abdominal pain (LAP) is a common presenting complaint that has a diverse etiology. It can involve reproductive, gastrointestinal, genitourinary, and musculoskeletal systems; therefore, accurate diagnosis is a clinical challenge. Laparoscopy has become the gold standard for the diagnosis and management of LAP. Aims and objectives: To diagnose the cause of LAP with laparoscopy and to correlate it with clinical examination and ultrasound. Materials and methods: A prospective study was conducted from December 2012 to January 2015 in JNMCH, Aligarh. Laparoscopy was performed on 84 patients with complaints of LAP (acute, subacute, or chronic). Data were statistically analyzed on the basis of the epidemiology, clinical features, ultrasound findings, and laparoscopic findings. Correlation of clinical, ultrasound, and laparoscopic finding was done. Results: With laparoscopy, diagnosis was established in 94.1% (n = 79) of patients. The most common cause of LAP was pelvic inflammatory disease (PID) present in 20.2% (n = 17) of patients followed by endometriosis in 17.9% (n = 15), ectopic pregnancy in 15.5% (n = 13), ovarian cyst in 15.5% (n = 13), genital TB in 7.1% (n = 6), etc. Therapeutic laparoscopy was performed in 82.1% (n = 69) of women, which included adhesiolysis, cystectomy, cystotomy, salpingectomy, salpingostomy fulguration of endometriotic lesions, ovarian drilling, myomectomy, and salpingo-ophorectomy. Conclusion: Laparoscopy can be used as the first-line interventional investigation for LAP. Besides diagnosis, it also has a therapeutic role. Therefore, it can be considered as a “see and treat” modality.


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  1. Rapkin AJ, Howe CN. Pelvic pain and dysmenorrhea. In Berek & Novak's Gynecology Berek JS 15th ed., Lippincott Williams & Wilkins; 2011. pp. 506–540.
  2. Karnath BM, Breitkopf DM. Acute and chronic pelvic pain in women. Hosp Physician 2007;0:41–48.
  3. RCOG 2012. Royal College of Obstetricians and Gynaecologists. The Initial Management of Chronic Pelvic Pain; Green–top Guideline No. 41, May 2012.
  4. Howard FM. Chronic pelvic pain. Am College Obstet and Gynecolog 2003;101(3):594–611. DOI: 10.1097/00006250-200303000-00029.
  5. Porpora MG, Gomel V. The role of laparoscopy in the management of pelvic pain in women of reproductive age. Fertil Steril 1997;68(5):765–779. DOI: 10.1016/s0015-0282(97)00192-1.
  6. Morino M, Pellegrino L, Castagna E, et al. Acute nonspecific abdominal pain a randomized, controlled trial comparing early laparoscopy versus clinical observation. Annals Surg 2006;244(6):881–888. DOI: 10.1097/01.sla.0000246886.80424.ad.
  7. Arya PK, Gaur KJBS. Laparoscopy: a tool in diagnosis of lower abdominal pain. Indian J Surg 2004;66:216–220.
  8. Al-Bareeq R, Dayna KB. Diagnostic laparoscopy in acute abdominal pain: 5-year retrospective series. Bahrain Med Bull 2007;29:1–5.
  9. Ali SAS, Moosa FA, Sultan N, et al. Role of diagnostic laparoscopy in recurrent vague abdominal pain. J Surg Pakistan (International) 2013;18(2):74–77.
  10. Baria KAK. Role of laparoscopy in diagnosis and management of chronic abdominal pain. Indian J Sci Res 2013;4(1):65–68.
  11. Kang S-B, Chung HH, Lee H-P, et al. Impact of diagnostic laparoscopy on the management of chronic pelvic pain. Surg Endosc 2007;21(6):916–919. DOI: 10.1007/s00464-006-9047-1.
  12. Moussa GI, Mahfouz AE. Role of laparoscopy in management of unexplained chronic abdominal pain. Egyptian J Surg 2004;23(1):22–29.
  13. Kumar A, Sarwar MY, Pandey NK. Role of diagnostic laparoscopy in nonspecific chronic abdominal pain: experience of 100 cases. J Evol Med Dent Sci 2013;2(48):9361–9366. DOI: 10.14260/jemds/1622.
  14. Teamma MS. Evaluation of laparoscopy in the management of abdominal emergencies. J Arab Soc Med Res 2013;8:19–25.
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