未确诊的右下腹疼痛患者获得诊断性腹腔镜检查。

Anil Reddy, Mohammad Fazelul Rahman Shoeb, S. Nasiruddin, H. M. Abhijith
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引用次数: 0

摘要

背景:常规检查和超声检查阴性的右下腹痛患者是外科医生面临的挑战。对许多病人来说剖腹手术是唯一的选择。腹腔镜检查被定义为通过器械通过腹壁上的小开口观察腹盆腔的技术。在RIF疼痛患者中,只有诊断性腹腔镜才能被认为是金标准,并提供正确的诊断,同时可能被证明是治疗目的:本研究的目的是评估腹腔镜在诊断不确定的右下腹痛中的作用。背景与设计:本前瞻性研究选取我院外科门诊就诊时间超过24个月,临床诊断、USG腹部及实验室检查不明确的右下腹痛患者进行诊断性腹腔镜检查。材料和方法:对174例患者进行诊断性腹腔镜检查。这些患者表现为右下腹部疼痛,并接受了同样的检查。结果:其中腹腔镜检查阳性170例(97.7%)。阑尾炎、妇科病理、腹部结核是主要表现。165例患者接受了治疗手术(腹腔镜158例)。本组病例中只有一例并发症,患者在术后第2天发生手术部位感染。因此,那些一直未被诊断的病人,被诊断出来并给予适当的治疗。结论:本研究确立了诊断性腹腔镜在未确诊的右下腹痛中作为一种安全且最多产的检查工具的作用。
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Acquisition of Diagnostic Laparoscopy in undiagnosed Right Lower Abdominal Pain Patients.
Background: Patients with right lower abdominal pain in whom routine investigations and sonography are negative, is challenging to the surgeons. In many patient’s laparotomy is the only alternative.Laparoscopy is defined as the technique in which abdomino-pelvic cavity is visualized through small openings in the wall of abdomen through instruments. In patients with RIF pain, only diagnostic laparoscopy can be considered as the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic Aim: The Aim of the study is to evaluate role of laparoscopy in right lower abdominal pain with uncertain diagnosis. Settings and Design: In this prospective study, patients with right lower abdominal pain with uncertain clinical diagnosis, USG abdomen and laboratorial investigation, coming to surgery OPD of our institute, over a period of 24 months were considered for Diagnostic Laparoscopy. Material and Methods: Diagnostic laparoscopy was performed in 174 patients. These patients presented with right lower abdominal pain and undergone investigations for the same. Results: Laparoscopy yielded positive findings in 170 (97.7%) of these patients. Appendicitis and gynaecological pathology, abdominal tuberculosis, were the major findings. Therapeutic procedures were performed in 165 patients (laparoscopically 158). There was only one complication in this series, in which patient developed surgical site infection on post-operative day 2. So, the patients who had remained as undiagnosed otherwise, were diagnosed and given appropriate treatment. Conclusion: This study establishes role of Diagnostic Laparoscopy as a safe and one of the most prolific investigative tools in undiagnosed right lower abdominal pain.
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