Role of Diagnostic Laparoscopy in Chronic Abdominal Pain with Uncertain Diagnosis: A 1-year Cross-sectional Study

Aim: Diagnosis of chronic abdominal pain is a significant clinical challenge. Laparoscopy, a minimally invasive technique, could potentially be diagnostic as well as therapeutic in patients with chronic undiagnosed abdominal pain. This study was aimed to evaluate the role of laparoscopy as an investigative modality in the diagnosis and management of patients with chronic abdominal pain. Materials and methods: Demographics, clinical data, and medical and surgical history of the patients (55 patients) with chronic abdominal pain were noted. Details of pain such as, severity of pain based on visual analog scale (VAS) score, duration of pain, site of pain, and nature of pain were recorded. Routine along with radiological investigations were also performed. After preoperative investigations, the patients were subjected to diagnostic laparoscopy, either by open or closed technique under general anesthesia. Postoperative assessment of pain was done using VAS score. Results: Most of the patients (65.45%) had a duration of pain between 8 weeks and 12 weeks and mean duration of pain was 10.80 ± 2.78 weeks. Fever was present in 41.82% of the patients. A history of lower segment cesarean section was observed in 5.45% patients. The most common surgical procedure performed was adhesiolysis (30.91%) followed by appendectomy (29.09%). Postoperative pain relief was statistically significant ( p < 0.001). Conclusion: Laparoscopy offers an effective diagnostic modality and excellent pain relief in the management of patients with chronic abdominal pain. Furthermore, adhesions and inflamed appendix are important causes of chronic abdominal pain. However, studies with a large sample size are required to validate the findings. Clinical significance: Laparoscopy is an investigative modality in the diagnosis and management of patients with chronic abdominal pain. underwent adhesiolysis. In a study by Husain et al., 6 patients with chronic abdominal pain had 19% and 17.3% cure rate with laparoscopic appendectomy and adhesiolysis, respectively, after a 6-month follow-up period. In a study by El-labban et al., 19 laparoscopic adhesiolysis resulted in a positive outcome in more than 50% patients.