Murat CİKOT, Eyup GEMİCİ, Ahmet SUREK, Sinan BİNBOGA, Bahadir KARTAL, Halil ALİS, Cevher AKARSU, Nuri Alper SAHBAZ

Laparoscopic approach for hospitalized women in reproductive period presenting with non-specific abdominal pain

Aim: The aim of this study is to evaluate nonspecific abdominal pain of hospitalized women in reproductive period and to make a contribution to the literature.Material and Method: Medical records from 201 women in reproductive period presenting with nonspecific abdominal pain admitted to emergency department between 2010 and 2014 are evaluated retrospectively.Results: Diagnostic laparoscopy was performed in 125 of 201 patients. The mean age of patients was 8.5 years, mean white blood cell (WBC) count:10.9 103/uL, mean C-reactive protein (CRP) levels: 2.6 mg/dl, mean preoperative follow-up time 7.8 hours, mean operation time 32 min., mean postoperative follow-up duration time was 15 hours. In ultrasonography, 38% of patients had minimal liquid in Douglas’s area. In Computerized Tomography (CT) with intravenous, oral-rectal contrast, 30% of patients had minimal liquid. In 89% of patients, who underwent laparoscopic exploration, cause of the abdominal pain was found. In 57 explorations, purulent fluid was detected and associated to pelvic inflammatory disease, in 42 patients sero-hemorrhagic fluid was detected and associated to hemorrhagic cyst rupture. 9 patients had acute appendicitis, 2 patients had Meckel’s diverticulitis and one patient had a left lower quadrant brid. Conclusion: Our results indicate that laparoscopy serves not only as diagnostic, but also as diagnostic tool for female patients in reproductive age with nonspecific abdominal pain.

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Brandt CP, Priebe PP, Jacobs DG. Potential of laparoscopy to reduce non-therapeutic trauma laparotomies. Am Surg 1994;60(6):416-20.
Sugarbaker PH, Sanders JH, Bloom BS, Wilson RE. Preoperative laparoscopy in diagnosis of acute abdominal pain. Lancet 1975;1(7904):442-5.
Curet MJ, Allen D, Josloff RK, Pitcher DE, Curet LB, Miscall BG, et al: Laparoscopy during pregnancy. Arch Surg 1996;131(5):546-50.
Brooks DC: Bedside laparoscopy in the critically ill ICU patient, In 1997 Sages Course Hand Book 1997. pp. 8-12
Amos JD, Schorr SJ, Norman PF, Poole GV, Thomae KR, Mancino AT, et al. Laparoscopic surgery during pregnancy. Am J Surg 1996;171(4):435-7.
Duh QY. Small bowel obstruction. In Toouli J, Gossot D, Hunter JG (eds): Endosurgery. New York, Churchill Livingstone, 1996. pp. 425-31.
Diehl JT, Eisenstat MS, Gillinov S, Rao D. The role of peritoneoscopy in the diagnosis of acute abdominal conditions. Cleve Clin Q 1981;48(3):325-30.
Cohen MM. Peritoneoscopy in general surgery. Can J Surg 1981;24:490-3.
Bouillot JL, Salah S, Fernandez F, al-Hajj G, Dehni N, Dhote J, et al. Laparoscopic procedure for suspected appendicitis. A prospective study in 283 consecutive patients. Surg Endosc 1995;9(9):957-60.
Berci G, Sackier JM, Paz- Partlow M. Emergency laparoscopy. Am J Surg 1991;161(3):332-5.
el Ghoneimi A1, Valla JS, Limonne B, Valla V, Montupet P, Chavrier Y, et al. Laparoscopic appendectomy in children: Report of 1,379 cases. J Pediatr Surg 1994;29(6):786-9.
Costalat G, Alquier Y. Combined laparoscopic and endoscopic treatment of perforated gastroduodenal ulcer using the ligamentum teres hepatis (LTH). Surg Endosc 1995;9(6):677-9.
Banez AV. Peritoneoscopy (also known as laparoscopy). Am J Proctol Gastroenterol Colon Rectal Surg 1980;31(10):7-8. 20.
Anteby SQ, Schenker JG, Polishuk WZ. The value or laparoscopy in acute pelvic pain. Ann Surg 1975;181(4):484-6.
Weigelt JA, Kingman RG. Complications of negative laparoto my for trauma. Am J Surg 1998;156(6):544-7.
Sugarbaker PH, Sanders JH, Bloom BS, Wilson RE. Preoperative laparoscopy in diagnosis of acute abdominal pain. Lancet 1975;1(7901):442-5.
Sosa JL, Baker M, Puente I, Sims D, Sleeman D, Ginzburg E, et al. Negative laparotomy in abdominal gunshot wounds: Potential impact of laparoscopy. J Trauma 1995;38(2):194-7.
Petersen SR, Sheldo GF. Morbidity of a negative finding at laparotomy in abdominal trauma. Surg Gynecol Obstet 19779;148(1):23-6.
Lowe RJ, Boyd DR, Folk FA, Baker RJ. The negative laparotomy for abdominal trauma. J Trauma 1972;12(10):853-61.
Forde KA, Ganepola GA: Is mandatory exploration for penetrating abdominal traumaextinct? The morbidity and mortality of negative exploration in a large municipal hospital. J TraumA 1974;14(9): 764-6.
Salky BA, Edye MB. The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes. SurgEndosc 1999;12:911-4.
Decadt B, Sussman L, Lewis MP, Secker A, Cohen L, Rogers C, et al. Randomized clinical trial of early laparoscopy in the management of acute non-specific abdominal pain. Br J Surg. 1999;86(11):1383-6.
Cuesta MA, Eijsbouts QAJ, Gordijn RV, Borgstein PF, de Jong D. Diagnostic laparoscopy in patients with an acute abdomen of uncertain etiology. Surg Endosc 1998;12:915-7.
Majeski W. Diagnostic laparoscopy for the acute abdomen and trauma. Surg Endosc 2000;14(10):930-7.