DOI: http://dx.doi.org/10.18203/2349-2902.isj20190472

A study of evaluation of chronic pain abdomen in pediatric patients by laparoscopy

Ravindra G. Khasnis, Rajshankar S.

Abstract


Background: Pain in abdomen of chronic nature is common in children but being so common difficult to determine the exact cause. It has been estimated that around 2-4% of all the pediatric patients attend the outpatient department are due to pain in the abdomen that is of chronic nature in children. It has been seen that routine diagnostic and therapeutic procedures fail to make a justice of the diagnosis and management for the pain in the abdomen of chronic nature. The aim was to study the role of laparoscopy in children with chronic pain abdomen.

Methods: Interventional follow up study was carried out among 19 children with pain in the abdomen of chronic nature. Detailed history pertaining to pain in the abdomen, history of surgical explorations was taken. As a part of the work up of a patient the investigations were done routinely. All children were evaluated by laparoscopy.

Results: Majority of the children were in the age group of 11-12 years i.e. 42.1%. Male and female children were almost equal in distribution. USG was diagnostic in 9 patients (47.36%). Laparoscopy was diagnostic in all 18 other cases (95% cases). 73.68% had not complication after the procedure. Only four patients had fever after the surgery and only one patient had wound infection. Thus, overall the laparoscopic procedure was very successful. Laparoscopy and USG were equally effective in diagnosing inguinal hernia.

Conclusions: Laparoscopy had better diagnostic value compared to ultrasonography. Laparoscopic intervention was successful with minimum complications.


Keywords


Chronic pain, Evaluation, Laparoscopy, Pediatric patients

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References


American academy of pediatrics. Subcommittee on chronic abdominal pain. Chronic abdominal pain in children. Pediatrics. 2005;115(3):812-5.

Gupta DK. Make laparoscopy a pediatric surgeon's armamentarium. J Ind Assoc Pediatric Surg. 2006;11(4):204.

Bremner AR, Sandhu BK. Recurrent abdominal pain in childhood: the functional element. Ind Pediatrics. 2009;46(5):375.

Carson L, Lewis D, Tsou M, McGuire E, Surran B, Miller C, et al. Abdominal migraine: an under‐diagnosed cause of recurrent abdominal pain in children. Headache: J Head Face Pain. 2011;51(5):707-12.

Kolts RL, Nelson RS, Park R, Heikenen J. Exploratory laparoscopy for recurrent right lower quadrant pain in a pediatric population. Pediatric Surg Inter. 2006;22(3):247-9.

Panchalingam L, Driver C, Mahomed AA. Elective laparoscopic appendicectomy for chronic right iliac fossa pain in children. J Laparo-endoscopic Advanced Surg Tech. 2005;15(2):186-9.

Charlesworth P, Mahomed A, Mahomed MA. Diagnostic laparoscopy and appendicectomy for children with chronic right iliac fossa pain: an aggregate analysis. J Pediatrics Surg Special. 2010;3:9-14.

Stringel G, Berezin SH, Bostwick HE, Halata MS. Laparoscopy in the management of children with chronic recurrent abdominal pain. JSLS: J Soc Laparo-endoscopic Surg. 1999;3(3):215.

Stylianos S, Stein JE, Flanigan LM, Hechtman DH. Laparoscopy for diagnosis and treatment of recurrent abdominal pain in children. J Pediatric Surg. 1996;31(8):1158-60.

DeCou JM, Gauderer MW, Boyle JT, Green JA, Abrams RS. Diagnostic laparoscopy with planned appendectomy: an integral step in the evaluation of unexplained right lower quadrant pain. Pediatric Surg Inter. 2004;20(2):123-6.

Budianto IR, Tan HL, Kinoshita Y, Tamba RP, Leiri S, Taguchi T. Role of laparoscopy and ultrasound in the management of “impalpable testis” in children. Asian J Surg. 2014;37(4):200-4.

World Laparoscopy Hospital. Laparoscopic management of undescended testis by Hazrat G, 2007. Available at: https://www.laparoscopyhospital.com/laparoscopic_management_of_undescended_testes.html. Accessed 15 October 2015.

PMY Tang MW, Chao NS, Wong BP, Kwok WK, Liu KK. Use of laparoscopy in the management of impalpable testis in children. HK J Paediatrics (new series). 2009;14(3):172-6.

Kumar A, Ramakrishnan TS. Single port laparoscopic repair of paediatric inguinal hernias: Our experience at a secondary care centre. J Min Access Surg. 2013;9(1):7.