Role of diagnostic laparoscopy in the evaluation of equivocal non-traumatic abdominal pain: A prospective study at a tertiary care centre

Abstract

Background: Equivocal non-traumatic abdominal pain often presents a diagnostic challenge despite clinical examination and imaging studies. Diagnostic laparoscopy offers a direct, minimally invasive means of establishing both diagnosis and treatment.

Aim: To evaluate the diagnostic accuracy, therapeutic potential, and clinical outcomes of diagnostic laparoscopy in patients presenting with equivocal non-traumatic abdominal pain.

Methods: This prospective observational study was conducted at GSL Medical College, Rajahmundry, from November 2019 to May 2020, involving 60 patients with undiagnosed non-traumatic abdominal pain after routine investigations. Following ethical approval and consent, patients underwent diagnostic laparoscopy under general anesthesia. Findings, therapeutic procedures, complications, and outcomes were recorded. Data were analyzed using SPSS version 21.0, with a p-value <0.05 considered significant.

Results: A definitive diagnosis was achieved in 92% of cases. Common pathologies included acute appendicitis (35%), pelvic inflammatory disease (18%), and mesenteric lymphadenitis (12%). Therapeutic intervention was performed in 80% of patients, while 8% required conversion to laparotomy. Diagnostic laparoscopy exhibited 94% sensitivity, 100% specificity, and minimal postoperative morbidity (5%).

Conclusion: Diagnostic laparoscopy is a reliable, accurate, and safe modality in the evaluation of equivocal non-traumatic abdominal pain, providing both diagnostic clarity and therapeutic advantage, while minimizing unnecessary laparotomies and complications.

Keywords: Diagnostic laparoscopy; Non-traumatic abdominal pain; Appendicitis; Pelvic pathology; Minimally invasive surgery.