title: The influence of diagnostic and therapeutic laparoscopy on patients presenting with an acute abdomen.
abstract: The role of laparoscopy in the management of patients presenting to one surgical firm with an acute abdomen is discussed. Sixty-seven laparoscopies have been performed over an 18 month period and it has altered the diagnosis in 19.4% of cases and the management in 13.4% of cases. At laparoscopy the diagnosis of appendicitis was made in 37 patients (81% had attempted laparoscopic appendicectomies); pelvic inflammatory disease in 15 patients; torted fimbrial cyst in two patients; and free pus in the right lower peritoneum as a result of a perforated appendix was seen in two patients. Normal laparoscopy was performed in five patients and four patients who presented with a perforated duodenal ulcer had the diagnosis confirmed at laparoscopy, in three cases the perforation was oversewn laparoscopically. Two laparoscopies were performed on trauma patients; one stabbing and one blunt trauma to the right hypochondrium. It has been demonstrated that diagnostic laparoscopy is a useful adjunct to the general surgeon's armamentarium. It is suggested that the skill of laparoscopy is passed on to junior trainee surgeons who can use this technique to help attain a diagnosis in patients presenting with an acute abdomen.
authors.affiliation: St Mary's Hospital, London, UK.
authors.forename: H J
authors.initials: HJ
authors.lastname: Scott
authors.forename: R D
authors.initials: RD
authors.lastname: Rosin
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology* / Q000628:therapy; D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000175:diagnosis; D014949:Wounds, Nonpenetrating / Q000150:complications; D014951:Wounds, Stab / Q000150:complications