[Diagnostic laparoscopy in nontraumatic acute abdomen]

Laparoscopy was performed in 49 patients admitted to the Emergency Service of Hospital das Clínicas of the Medical School of the University of São Paulo with a possible diagnosis of acute non traumatic abdomen. The procedure was indicated because routine clinical and laboratory investigations had proved inconclusive. Accuracy (96%), sensitivity (97.5%), specificity (89%) and positive (97.5%) and negative (89%) predictive values of laparoscopy were assessed in 41 patients with a clinical suspicion of inflammatory acute abdomen, in 5 with a clinical diagnosis of vascular abdomen, in 1 with a perforative acute abdomen, and in 2 patients to assess the viability of the small bowel after and intestinal resection due to mesenteric ischemia. Laparoscopy proved to be a reliable and simple procedure which facilitated the choice of the best therapeutic alternative in each case. A significant number of unnecessary laparotomies was avoided. No complications imputable to laparoscopy were observed in this series.