Abstract

Appendectomy is the most common general surgical operation. Eighty percent of these operations are proved to cause some sort of intra-abdominal adhesions that could be symptomatic. In this study, we aimed at assessment of laparoscopic diagnosis and treatment of post appendectomy abdominal pain (PAAP).

This study was performed on patients with PAAP, who presented to the Department of Surgery of Assiut University Hospital in the period between January 2000 and January 2002. After clinical and investigatory assessment, only patients with no evident cause of pain were included. Diagnostic laparoscopy was done to all patients with adhesiolysis if needed.

Nineteen patients, 12 females and 7 males, were included, with a mean age of 28.3 years. All patients presented with unremitting PAAP. The period between appendectomy and presentation ranged from 4 to 14 months. Postoperative adhesions were found to be the main cause of pain in 18 patients. One patient had normal laparoscopic finding. Laparoscopic adhesiolysis was completed in 17 patients. In the remaining case conversion to open adhesiolysis was needed. Inadvertent injury of the caecum occurred in one patient and the bladder in another (11.1%), both of which were repaired laparoscopically. After a mean follow up period of 10.8 months, marked improvement of symptoms was noticed using visual analogue pain scale assessment.

In conclusion, laparoscopy could be considered as an effective tool for management of patients with PAAP secondary to adhesions.