Non-traumatic acute abdomen: videolaparoscopic approach

JSLS. 1999 Jul-Sep;3(3):187-92.

Abstract

Background and objective: Although videolaparoscopy has been considered a safe method for many elective procedures, its use in traumatic and non-traumatic acute abdomen needs to be evaluated. The aim of this article is to evaluate the role of videolaparoscopy in non-traumatic acute abdomen as a method of diagnosis and treatment.

Methods: Between January 1992 and December 1996, 462 patients' charts were reviewed, retrospectively. Patients were admitted to the emergency room of São Rafael Hospital with symptoms of non-traumatic acute abdomen. Routine investigation of abdominal pain was performed in all patients, followed by videolaparoscopy. The laparoscopic procedures were done with four main purposes: diagnosis (ie, enteritis); diagnosis and treatment (ie, appendicitis); treatment only, when the diagnosis was known (ie, acute cholecystitis); and in cases where the conversion to conventional laparotomy was necessary, indicating the best incision.

Results: The vast majority of patients had inflammatory causes of acute abdomen (82.03%); others causes were hemoperitoneum (11.03%), bowel obstruction (3.25%), perforation of a hollow viscera (1.74%), vascular occlusion (1.3%), and negative laparoscopy (0.65%).

Conclusions: This study shows that laparotomy was necessary in only 7.14% of the patients. The videolaparoscopic approach was used for diagnosis (99.35%) and treatment (92.86%) of patients with acute abdomen.

Publication types

  • Comparative Study

MeSH terms

  • Abdomen, Acute / diagnosis*
  • Abdomen, Acute / surgery*
  • Brazil
  • Emergency Service, Hospital
  • Endoscopy / methods
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Retrospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome
  • Video-Assisted Surgery*