head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue4
Subject Area: Medicine
DOI: 10.5272/jimab.2019254.2843
Published online: 16 December 2019

Original article

J of IMAB. 2019 Oct-Dec;25(4):2843-2846;
Konstantin KostovORCID logo Corresponding Autoremail,
Department of General, Visceral and Emergency Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine “N. I. Pirogov” – Sofia, Bulgaria.

Purpose: The purpose of this study is to analyze the role of emergency laparoscopy to provide the diagnosis in patients with history of acute abdominal pain, where physical examination and diagnostic tests are unrevealing-unclear emergency cases. Also important is to demonstrate the clinical indications as well as the results of urgent laparoscopic surgery in acute abdominal diseases.
Material and Methods: A total of 756 patients with a diagnosis of the acute non-traumatic abdomen were hospitalized for a period of two years from 1.1.2014 to 1.1.2016 in the Department of General, Visceral and Emergency Surgery at UMHATEM "Pirogov". Of these, women were 402 (53.17%), men 354 (46.83%).The age in this retrospective analysis varied from 18 to 79 years (average 51.3).
Results: Patients divided into 3 groups by suspected diagnosis.
Operations for acute abdomen in group I (711 patients-94.05%) include inflammatory disease-acute cholecystitis, acute appendicitis, ruptured ovarian cyst and acute pancreatitis. Diagnostic accuracy of laparoscopy was 100%.
A total of 26 patients(3.44%) with perforated abdominal viscus (group II) were operated laparoscopically. Diagnostic accuracy of laparoscopy was also 100%.
Of the 19 operated patients (2.51%) for acute intestinal obstruction and mesenteric ischaemia(group III), women were 7, male 12. Diagnostic accuracy of laparoscopy was 100%. Conclusions: Laparoscopy provided a diagnosis in a large number of patients. It is a very good diagnostic and therapeutic tool. It should be a first-line surgical investigation for undiagnosed abdominal pain with no specific etiology.

Keywords: acute non-traumatic abdomen, peritonitis, approach, conventional surgery, laparoscopy,

pdf - Download FULL TEXT /PDF 501 KB/
Please cite this article as: Kostov K. Specific features and capabilities of emergency laparoscopy in the acute non-traumatic abdomen. J of IMAB. 2019 Oct-Dec;25(4):2843-2846.
DOI: 10.5272/jimab.2019254.2843

Corresponding AutorCorrespondence to: Konstantin Kostov, MD, PhD; 3rd Surgical Clinic, UMHATEM “N. I. Pirogov”; 21, Totleben Blvd., 1606 Sofia, Bulgaria; E-mail: dr.k.kostov@gmail.com

1. Sheridan WG, White AT, Havard T, Crosby DL. Non‑specific abdominal pain: the resource implications. Ann R Coll Surg Engl. 1992 May;74(3):181-5. [PubMed]
2. Lightdale CJ. Laparoscopy in the age of imaging. GastrointestEndosc. 1985 Feb;31(1):47-48.
3. Vander Velpen GC, Shimi SM, Cuschieri A. Diagnostic yield and management benefit of laparoscopy: A prospective audit. Gut. 1994 Nov; 35(11):1617-21. [PubMed] [Crossref]
4. Paajanen H, Julkunen K, Waris H. Laparoscopy in chronic abdominal pain: A prospective nonrandomized long-term follow-up study. J Clin Gastroenterol. 2005 Feb; 39(2):110-4. [PubMed]
5. Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain. Surgery. 2003 Oct; 134(4):549-52. [PubMed] [Crossref]
6. Navez B, Navez J. Laparoscopy in the acute abdomen. Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):3-17 [PubMed] [Crossref]
7. Samsonov VT, Ermolov AS, Gulyaev AA, Yartsev PA, Levitsky VD, Rogal MM. [Laparoscopy in emergency abdominal surgery.] [in Russian] Khirurgiia (Mosk). 2019; (9):32-37. [PubMed]
8. Gupta P, Rajapandian S, Sabnis SC, Palanivelu C. Laparoscopic management of an unusual case of small bowel obstruction: appendiculoileal knotting. BMJ Case Rep. 2018 Jul 23;2018. pii: bcr-2018-224640. [PubMed] [Crossref]
9. Atanasov T, Vrachanski D, Filipov A, Radenovski D. Laparoscopic approach to small bowel obstruction. Journal of Emergency Medicine. 2009 16(1):4-11
10. Atanasov T. Single Incision Laparoscopic Appendectomy: A transumbilical scarless operation. Journal of Emergency Medicine. 2009 16(2):23-29
11. Saeian K and Reddy KR. Diagnostic laparoscopy: Endoscopy 1999 Jan;31(1):103-9. [PubMed]
12. Boyd WP Jr, Nord HJ. Diagnostic laparoscopy: Endoscopy 2000 Feb;3(2):153-8. [PubMed]
13. Majewski W. Diagnostic laparoscopy for the acute abdomen and trauma: SurgEndlosc 2000 Oct;14(10):930-37. [PubMed]
14. Karnam US and Reddy KR. Diagnostic laparoscopy- an update: Encdoscopy 2002 Feb;34(2):146-53. [PubMed]
15. Reinmann JF. Diagnostic laparoscopy: Endoscopy 2003 Jan;35(1):43-7. [PubMed]
16. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg 2002 Jul;137(7):799-804. [PubMed]
17. Nagy A, James D: Diagnostic Laparoscopy. Am J Surg 1989 May;157(5):490-3. [PubMed]
18. Hackenberg TP, Mentula A, Leppaniemi V. Sallinen. Laparoscopic versus open surgery for acute adhesive small-bowel obstruction: A propensity score-matched analysis. Scandinavian J Surg. 2017 Mar;106(1):28-33. [PubMed]
19. Sjövall S, Kokki M, Kokki H. Laparoscopic surgery: a narrative review of pharmacotherapy in pain management. Drugs. 2015 Nov;75(16):1867-89. [PubMed]
20. Mayumi T. Highlights of topic “Practice Guidelines for Primary Care of Acute Abdomen 2015”. J Hepatobiliary Pancreas Sci. 2016;23(1):1-2.
21. Mayumi T, Yoshida M, Tazuma S, Furukawa A, Nishii O, Shigematsu K, et al. The Practice Guidelines for Primary Care of Acute Abdomen 2015. Jpn J Radiol. 2016 Jan;34(1):80-115. [PubMed]
22. Lee C, Kao L, Lin H, Wei P. Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study. World J Surg Oncol. 2015 Aug 15;13:250 [PubMed]

Received: 18 March 2019
Published online: 16 December 2019

back to Online Journal