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Laparoscopy in management of abdominal pain in children
Avinash V Joshi1, Beejel V Sanghvi, Hemanshi S Shah
1Department of Pediatric Surgery, Seth G.S Medical College, Mumbai, India.
Insights
Diagnostic laparoscopy offers a swift and accurate diagnosis for acute abdominal pain in children, avoiding treatment delays. Early use in recurrent abdominal pain cases is cost-effective and reduces school absences.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Abdominal pain is a common pediatric complaint.
- Diagnostic challenges exist for acute and recurrent abdominal pain in children.
Purpose of the Study:
- To evaluate the role of diagnostic and therapeutic laparoscopy in pediatric abdominal pain.
- To assess its efficacy in acute and recurrent cases.
Main Methods:
- Study included 54 children under 12 with acute (<72 hours) or recurrent abdominal pain.
- Exclusion criteria: hemodynamic instability and generalized peritonitis.
- Comprehensive evaluation including history, investigations, and specific tests for rare causes.
Main Results:
- Diagnostic laparoscopy enabled prompt, accurate diagnosis in acute abdomen cases.
- It avoided therapeutic delays and unnecessary hospital observation.
- Early laparoscopy for chronic pain reduced low-yield imaging and school absenteeism.
Conclusions:
- Laparoscopy is a valuable tool for diagnosing and treating pediatric abdominal pain.
- It offers diagnostic accuracy, efficiency, and economic benefits.
- Minimally invasive approaches improve patient outcomes and reduce healthcare costs.
Abstract:
The aim of our study was to evaluate the role of diagnostic and therapeutic laparoscopy for abdominal pain in children. Fifty-four children under the age of 12 years who presented with an acute abdomen with symptoms of duration of less than 72 hours (N = 21), and recurrent abdominal pain (RAP) with duration of symptoms ranging from 2 to 18 months (N = 33) were included in this study. Patients who presented with hemodynamic instability and signs of generalized peritonitis were excluded from this study. All patients were evaluated thoroughly, including a detailed history with relevant investigations and other specific tests, such as the Mantoux test, urinary porphobilinogen, video electroencephalograph, M. tuberculosis polymerase chain reaction, and so on, were taken to rule out rare causes of RAP. The results of the study were assessed, and it is concluded that diagnostic laparoscopy allows for establishing a prompt, accurate diagnosis in the acute abdomen without a therapeutic delay and unnecessary hospital observation. Laparoscopy early in the course of debilitating chronic abdominal pain in children provides economic benefit by eliminating many low-yield imaging studies and also minimizes lost time from school.
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