Evaluation of laparoscopy in the management of the suspected cases of acute appendicitis

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Abstract

Context
Differential diagnosis of right lower quadrant abdominal pain is a major public health problem. The clinical features and special investigations are all nonspecific, and the list of differential diagnosis is long indeed. One-third of unnecessary appendectomies performed in women of child-bearing period are avoidable by emergency diagnostic laparoscopy.
Aim
The aim was to evaluate the role of laparoscopy in diagnosis of causes of acute lower abdominal pain, which mimic acute appendicitis and perioperative outcome.
Settings and design
During the period from April 2014 to April 2018, this prospective study was conducted at Mansoura Emergency and University Hospitals, Department of General Surgery, on 60 patients having suspected acute appendicitis.
Patients and methods
Laparoscopy was done for all patients of suspected acute appendicitis for diagnostic and therapeutic purposes.
Statistical analysis used
Careful analysis of the data was done using Statistical Package for the Social Sciences program, version 26.
Results
Diagnostic laparoscopy was able to settle the correct diagnosis in 58 (96.6%) patients with high diagnostic accuracy. Moreover, it was able to save patients from unnecessary explorations. Operative time for the studied patients was a mean of 35.1±4.9 min.
Conclusion
Clinical diagnosis and laparoscopy were complementary in diagnosis of acute appendicitis and acute right lower abdominal pain. Laparoscopic assessment was advantageous in cases of diagnostic uncertainty. laparoscopic appendectomy caused fewer complications, diminished pain, shortened convalescence, and reduced hospital stay. Removal of an apparently normal appendix was recommended if no other pathology was found at laparoscopy.

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