ROLE OF DIAGNOSTIC LAPAROSCOPY IN EVALUATION AND TREATMENT OF CHRONIC ABDOMINAL PAIN IN CHILDREN: A FIVE YEARS DATA

Authors

  • Nabila Talat Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore
  • Muhammad Afzal Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore
  • Sarfraz Ahmad Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore
  • Naima Rasool Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore
  • Arsalan Raza Wasti Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore
  • Muhammad Saleem Department of Paediatric Surgery, Children Hospital & Institute of Child Health, Lahore

Abstract

Background: Chronic abdominal Pain in children is a very common cause of hospital admission. Many of them are discharged without a diagnosis even after battery of investigations. Laparoscopy plays a significant role in diagnosis and management of many causes of acute and chronic abdominal pain. The purpose of this study was to determine the efficacy of laparoscopy as an efficient diagnostic and management tool in children with chronic abdominal pain. Methods: A descriptive, prospective case series was collected in the department of Paediatric surgery Mayo’s Hospital Lahore, over the period of 5 years between Jan 2007- Dec 2013. The data of consecutive 50 patients, who were admitted in the department with the diagnosis of chronic abdominal pain, was recorded. All patients who had 2-3 admissions in hospital for last 2 months and failed to establish a definitive diagnosis after clinical examination and base line investigations underwent laparoscopy. The details of associated symptoms, finding of laparoscopy, laparoscopic procedures done, definitive diagnosis, histopathology, complications and relief of symptoms were collected and analysed and results were evaluated using SPSS17. Results: Out of 50 patients studies, 27/50 (54%) were male, 23/50 (46%) were female. Age ranged from 2–12 years, with the mean age of 7.24 year. Tuberculosis abdomen, adhesions, mesenteric lymphadenitis, appendicitis and cholecystitis were the final diagnosis. Five abdomens were found normal on laparoscopy. Complete pain relief was achieved in 30/50 (60%), reduced intensity of pain was gained in 12/50 (24%) cases while 16 % (8/50) still complained of pain. Conclusions: Laparoscopy is an efficient diagnostic and treatment tool in children with chronic unexplained abdominal pain. It avoids serial examinations; prolong admission, battery of investigations and unnecessary surgeries.

References

Ramchandani PG, Stein A, Hotopf M, Wiles NJ. Early parental and child predictors of recurrent abdominal pain at school age: results of a large population-based study. J Am Acad Child Adolesc Psychiatry 2006;45:729–36.

Oberlander TF, Rappaport LA. Recurrent abdominal pain during childhood. Pediatr 1993;14(8):313–9.

El-Labban GM, Hokkam EN. The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain. J Minim Access Surg 2010;6(4):95–9.

Holocomb GW. Laparoscopic cholecystectomy Surg Innov 1998;5(1):2–8.

Ramakrishna H. Laparoscopy, A tool in diagnosis of lower abdominal pain. Indian J Surg 2004;66(6):377.

Saeed M, Ayyaz M, Cheema MA (2003). Role of laparoscopy- a diagnostic aid, its indication and benefits. Ann King Edward Med Coll 2003;9:232–4.

Spaner SJ, Warnock GL. A brief history of endoscopy, laparoscopy, and laparoscopic surgery. J Laparoendosc Adv Surg Tech A 1997;7(6):369–73.

Ruchi R, Singh S. Challenges in Paediatric Laparoscopic Surgeries. Indian J Anaesth 2009;53(5):560–6.

Stringel G, Berezin SH, Bostwick HE, Halata MS. Laparoscopy in the Management of Children with Chronic Recurrent Abdominal Pain. JSLS 1999;3(3):215–9.

Baria KA. "Role of Laparoscopy in Diagnosis and Management of Chronic Abdominal Pain."Indian J Sci Res 2013;4(1):65–8.

Tulaskar N, Nichkaode P, Dasgupta S, Choudhary A, Zamad R, Panchbhai K. Evaluation of role of laparoscopy in chronic abdominal pain. Int J Biol Med Res 2013;4(2):3230–3.

Chahed J, Mekki M, Mansour A, Ben Brahim M, Maazoun K, Hidouri S, et al. Contribution of laparoscopy in the abdominal tuberculosis diagnosis: retrospective study of about 11 cases. Pediatr Surg Int 2010;26(4):413–8.

Lin YS, Huang YC, Lin TY. Abdominal tuberculosis in children: a diagnostic challenge. J Microbiol Immunol Infect 2010;43(3):188–93.

Rai S, Thomas WM. Diagnosis od abdominal tubercolosis: the importance of laparoscopy. J R Soc Med 2003;96(12):586–8.

Mohamed A, Bhat N, Abukhater M, Riaz M. Role of Laparoscopy in Diagnosis of Abdominal Tuberculosis. The Internet J Infect Dis 2009;8:2.

Shapiro M, Nquyen M. Pshycological stress and abdominal pain in adolescence. Ment Health Fam Med 2010;7(2):65–9.

Bhandarkar DS, Shah RS, Katara AN, ShankarM, Chandiramani VA, Udwadia TE. Laparoscopic biopsy in patients with abdominal lymphadenopathy. J Minim Access Surg 2007;3(1):14–8.

Kavic SM, Kavic SM. Adhesions and adhesiolysis: The role of laparoscopy. JSLS 2002;6(2):99–109.

Pandza H, Custović S, Cović R, Delibegovic S. Laparoscopic treatment of lower abdominal pain related to chronic appendicitis. Med Arch 2008;62(5-6):268–70.

Moussa GI, Mahfouz AE. Role of laparoscopy in management of un explained chronic abdominal pain. Egypt J Surg 2004;23(1):22–9.

Published

2016-03-10

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