Background
Acute nonspecific abdominal pain (NSAP) is frequently encountered in the daily medical practice. This prospective study was performed to elucidate the role of early laparoscopy in the management of NSAP and to compare it with active clinical observation in such cases.
Patients and methods
A total of 100 cases with acute NSAP were randomly divided into two groups: early diagnostic laparoscopy (EDL) group included 50 cases who underwent EDL, and observational group included the remaining 50 cases who were closely observed. Outcome measures included the definitive diagnosis, operative time, duration of hospitalization, and postoperative morbidity.
Results
No statistically significant difference was noticed between the study groups regarding demographics. However, the duration of symptoms showed significant prolongation in the observation group. Regarding the final definitive diagnosis, no significant difference was noticed between the two groups (<0.001). No definite diagnosis was reached in 12 and 52% of cases in the EDL and observation groups, respectively. In the observation group, 18 cases underwent laparoscopic assessment after admission (36%). The duration of hospitalization was significantly prolonged in the observational group. In addition, both recurrence and readmission were more reported in the same group during 15-day and 6-month follow-up visits.
Conclusion
Diagnostic laparoscopy appears to be a reliable tool to reach a definite diagnosis in patients with NSAP because of its superior diagnostic ability, better visualization, low complications, and the ability to manage the pathology in the same setting.