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Is diagnostic laparoscopy justified in children with recurrent abdominal pain?

Ist die diagnostische Laparoskopie bei Kindern mit rezidivierenden abdominellen Schmerzen gerechtfertigt?

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Summary

Background: Diagnostic laparoscopy is a well established procedure for clarifying recurring pain of the lower abdomen in adults, and especially in young women. Concomitant appendectomy, however, is a controversial subject.

Methods: Our descriptive data analysis reports about diagnostic laparoscopy and concomitant appendectomy performed on 52 children with recurrent abdominal pain during a 2-year-period.

Results: We found adhesions, inflammation of the adnexes, and ovarian cysts. Histological examinations revealed pathologic findings in 25% of the removed appendices even if they appeared bland. Coproliths were found in 25% of cases. 93% of patients were free of pain and remained so during the entire follow-up period of a mean 75.8 days.

Conclusions: Diagnostic laparoscopy and concomitant appendectomy are an appropriate measure of diagnosis in children with recurrent abdominal pain and often are curative as well.

Zusammenfassung

Grundlagen: Die diagnostische Laparoskopie ist bei der Abklärung chronisch rezidivierender Unterbauchschmerzen bei Erwachsenen unumstritten. Kontroversiell wird die begleitende Appendektomie beurteilt. Daß dieses Vorgehen auch bei Kindern und Jugendlichen sinnvoll ist, soll anhand der Ergebnisse unserer Patienten gezeigt werden.

Methodik: Wir berichten in einer deskriptiven Analyse über 52 Kinder, die wegen rezidivierender Bauchschmerzen einer diagnostischen Laparoskopie unterzogen wurden. Bei 96% wurde eine begleitende Appendektomie durchgeführt.

Ergebnisse: Wir fanden Adhäsionen, Entzündungen der Adnexe und Zysten des Ovars. In der histologischen Untersuchung fand sich in 25% eine pathologisch veränderte Appendix, auch bei makroskopisch blander Appendix. In 25% fanden sich Kotsteine. 93% der Patienten waren nach der Operation schmerzfrei und blieben schmerzfrei, bei einer Nachuntersuchungszeit von durchschnittlich 75,8 Tagen.

Schlußfolgerungen: Die diagnostische Laparoskopie und begleitende Appendektomie ist auch im Kindesalter zur Diagnosefindung geeignet und häufig kurativ.

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Authors and Affiliations

  1. Department of General Surgery, University of Vienna, Austria

    A. Urbania

  2. Department of Anesthesiology, University of Vienna, Austria

    C. H. Glaser

  3. Division of Biomedical Sciences, University of Vienna, Austria

    M. Mittlböck

  4. Division of Pediatric Surgery, Department of General Surgery, Medical School, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna

    K. Paya M.D., W. Rebhandl, K. Leberl & E. Horcher

Authors
  1. K. Paya M.D.
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  2. W. Rebhandl
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  3. A. Urbania
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  4. K. Leberl
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  5. C. H. Glaser
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  6. M. Mittlböck
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  7. E. Horcher
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Correspondence to K. Paya M.D..

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Paya, K., Rebhandl, W., Urbania, A. et al. Is diagnostic laparoscopy justified in children with recurrent abdominal pain?. Acta Chir Austriaca 30, 344–345 (1998). https://doi.org/10.1007/BF02620092

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  • DOI: https://doi.org/10.1007/BF02620092

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