[Emergency laparoscopy. A 20-year experience].
We revised 7988 laparoscopies over twenty years. Three hundred and ninety three were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is made in patients with, both spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours with the usual clinical and imaging methods. Acute diffuse peritonitis was the commonest finding in the first group (21%) and splenic rupture in the traumatic group (34%). There were two severe complications (0.5%): pulmonary oedema in a patient with myocardial disease and a respiratory failure in a old patient, which were resolved. We had two deaths related to laparoscopic diagnosis: massive mesenteric thrombosis and fecal peritonitis. There are few contraindications and tolerance is very good. This study shows a sensitivity of 98%, a specificity of 90%, a predictive positive value greater than 98% and a negative predictive value of 100%. In summary, the present study demonstrates that emergency laparoscopy is a effective diagnostic method in acute abdominal pain of uncertain aetiology.
Martín-Vivaldi
R
R
Servicio de Aparato Digestivo Hospital, Virgen de las Nieves, Granada.
Nogueras
F
F
García Montero
M
M
Quintero
D
D
De Teresa
F J
FJ
D000006:Abdomen, Acute / Q000175:diagnosis* / Q000209:etiology; D000007:Abdominal Injuries / Q000175:diagnosis*; D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D004630:Emergencies; D004715:Endometriosis / Q000175:diagnosis; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010048:Ovarian Cysts / Q000150:complications / Q000175:diagnosis; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D012488:Salpingitis / Q000175:diagnosis
Laparoscopia de urgencia. Experiencia de 20 años.