Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1993 December; 86(12): 699–701.
PMCID: PMC1294359

The influence of diagnostic and therapeutic laparoscopy on patients presenting with an acute abdomen.


The role of laparoscopy in the management of patients presenting to one surgical firm with an acute abdomen is discussed. Sixty-seven laparoscopies have been performed over an 18 month period and it has altered the diagnosis in 19.4% of cases and the management in 13.4% of cases. At laparoscopy the diagnosis of appendicitis was made in 37 patients (81% had attempted laparoscopic appendicectomies); pelvic inflammatory disease in 15 patients; torted fimbrial cyst in two patients; and free pus in the right lower peritoneum as a result of a perforated appendix was seen in two patients. Normal laparoscopy was performed in five patients and four patients who presented with a perforated duodenal ulcer had the diagnosis confirmed at laparoscopy, in three cases the perforation was oversewn laparoscopically. Two laparoscopies were performed on trauma patients; one stabbing and one blunt trauma to the right hypochondrium. It has been demonstrated that diagnostic laparoscopy is a useful adjunct to the general surgeon's armamentarium. It is suggested that the skill of laparoscopy is passed on to junior trainee surgeons who can use this technique to help attain a diagnosis in patients presenting with an acute abdomen.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (501K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Adams ID, Chan M, Clifford PC, Cooke WM, Dallos V, de Dombal FT, Edwards MH, Hancock DM, Hewett DJ, McIntyre N, et al. Computer aided diagnosis of acute abdominal pain: a multicentre study. Br Med J (Clin Res Ed) 1986 Sep 27;293(6550):800–804. [PMC free article] [PubMed]
  • Vipond MN, Paterson-Brown S, Tyrrell MR, Coleman D, Thompson JN, Dudley HA. Evaluation of fine catheter aspiration cytology of the peritoneum as an adjunct to decision making in the acute abdomen. Br J Surg. 1990 Jan;77(1):86–87. [PubMed]
  • Paterson-Brown S, Eckersley JR, Sim AJ, Dudley HA. Laparoscopy as an adjunct to decision making in the 'acute abdomen'. Br J Surg. 1986 Dec;73(12):1022–1024. [PubMed]
  • Paterson-Brown S, Vipond MN, Simms K, Gatzen C, Thompson JN, Dudley HA. Clinical decision making and laparoscopy versus computer prediction in the management of the acute abdomen. Br J Surg. 1989 Oct;76(10):1011–1013. [PubMed]
  • Leape LL, Ramenofsky ML. Laparoscopy for questionable appendicitis: can it reduce the negative appendectomy rate? Ann Surg. 1980 Apr;191(4):410–413. [PubMed]
  • Jones PF. Practicalities in the management of the acute abdomen. Br J Surg. 1990 Apr;77(4):365–367. [PubMed]
  • Berci G, Sackier JM, Paz-Partlow M. Emergency laparoscopy. Am J Surg. 1991 Mar;161(3):332–335. [PubMed]
  • Anteby SO, Schenker JG, Polishuk WZ. The value of laparoscopy in acute pelvic pain. Ann Surg. 1975 Apr;181(4):484–486. [PubMed]
  • Nagy AG, James D. Diagnostic laparoscopy. Am J Surg. 1989 May;157(5):490–493. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press