Relaparoscopy in the management of acute abdomen due to localized ischemic bowel: a novel technique--case report.
Diagnostic and therapeutic laparoscopy for acute abdomen has been widely reported in the literature. Diagnostic laparoscopy has an accuracy of 99.08% and 1% morbidity. The usefulness of relaparoscopy in acute abdomen has also been reported. We describe a patient with acute abdominal pain who underwent diagnostic laparoscopy. Ischemic segment of small bowel was found and it was decided not to resect but to go in for a second look 48h later. Relaparoscopy revealed the ischemic segment to regain vascularity, so nothing further was done. The patient recovered well and was discharged on the 6th postoperative day. Laparotomy was avoided both the times, thus sparing the patient of morbidity and prolonged hospital stay. Other advantages are lower risk of incisional hernias, less postoperative pain and early return to normal activity. Laparoscopy and relaparoscopy certainly has a definite role in the management of acute abdomen, at least diagnostic if not therapeutic.
Palanivelu
Chinnusamy
C
GEM Hospital, Surgical Gastroenterology & MAS, 45-A, Pankaja Mill Road, Ramanathapuram, Coimbatore 641045, India.
Rangarajan
Muthukumaran
M
Maheshkumaar
Gobi Shanmugam
GS
Rajan
Pidigu Seshiar
PS
D000006:Abdomen, Acute / Q000209:etiology*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology; D007421:Intestine, Small; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D010535:Laparoscopy; D008875:Middle Aged; D012086:Reoperation