Laparoscopy in the context of lower abdominal pain in young women

The management of lower abdominal pain in young women carries up to 45% chance of diagnostic error. Laparoscopic management may be particularly beneficial in this subset of patients. This study reviews the authors' experience with laparoscopy as a potential diagnostic and therapeutic tool in young women with lower abdominal pain. The authors analyzed 121 consecutive female patients, with a mean age of 30 years, who were evaluated from June 1995 to October 1997. All patients were managed by early laparoscopy within 24 h from the onset of symptoms. Radiographic imaging, including computed tomography and ultrasound, was performed in 79 patients (65.2%). Laparoscopy was diagnostic in all cases. In 58 patients (48%), multiple pathologic conditions were identified. Acute appendicitis was the most common diagnosis (82.6%), and benign gynecologic disorders was the predominant reason for multiple pathologic conditions (clinical evaluation was erroneous in 15% of patients). In 96% of patients, definite surgical treatment was provided laparoscopically. The mean hospitalization time was 2.0 +/- 1 days, and the mean operative time was 59.8 +/- 21 min. The overall complication rate was 2.5%. In young women, early laparoscopy can offer a safe and effective alternative for the definite diagnosis and treatment of lower abdominal pain.