Posted: August 6th, 2021
Methods :-A possible study by following up of 60 victims of acute abdomen was executed. (all of studied cases have been investigated first by ultrasonography and X-ray of chest and abdomen ) .Therapeutic course of have been carried out consistent with state of affairs recognized. All victims have been adopted up 1 12 months from surgical process. Outcomes:-An entire of 60 cases have been analyzed . 1-48 Victims (80%) have been completed successively as diagnostic and therapeutic laparoscopy. A- Appendicectomy was carried out in 30 (50%) victims. B-Peptic perforations restore carried out in( 9 ) PATIENTS (15%) . C-Adhesolysis 6 victims(10%) . D-Enteric perforations have been (three) victims(5%) .———————————2-12victims (20%) have been led to a number of strategies as follows—————–A-6patients (10%) have been lap needed(assisted) open surgical process.
three tough appendectomy e.g difficulties 2 and 1cecal involvement &three tough ovarian 2cysts gangrenous and 1hudge perforated . B-3Laparascopic surgical procedures remodeled to classical open surgical process first ruptured hydatid cyst. 2nd ischemic(gangrenous)bowel 3rdruptured uterus C-3patients the place classical laparotomy have been averted as followings——1st affected individual was recognized as major peritonitis. 2nd appendicular mass who was dealt with by Oschner”Sheren method (conservatively) third pelvic abscess who was dealt with by lavage and tube drainage and antibiotics with out need for (opening of abdomen)or laparotomy.
——– 5percentof cases(6 pat)needed open srgery.60% of cases(36)victims have been discharged inside 2 days 30% discharged three”5 days.10%dicarged (6-7)days. Conclusion:- Diagnostic laparoscopy is a golden instrument in acute abdomen.it aids the right evaluation —it eliminates un justified laparotomy. Early discharge from hospital –decreases morbidity . Key phrases:-Acute abdomen”Diagnostic laparoscopy ” Therapeutic laparoscopy” laparoscopic assisted open surgery-open laparotomy. Introduction :-Acute abdomen is a sudden excessive abdomen ache .It is in a number of cases a surgical emergency requiring urgent and specific evaluation .
Plenty of causes need surgical remedy. The precept causes are acute appendicitis”acute peptic ulcer perforation “acute cholecystitis”acute pancreatitis – .Acute abdomen is commonly used synonymously with peritonitis .Whereas this is not completely incorrect peritonitis is additional specific time interval referring to irritation of peritoneum. basically probably the most specific discovering is rigidity.it manifest on bodily examination as rebound tenderness. in emergency division and need simultaneous speedy medical(historic previous—examination and actions)which are essential for early appropriate evaluation & remedy .The prognosis of victims rely on the experiences of medical staff acquired and managed them. The diagnostic laparoscopy is a model new method helps surgeon to take a look at clearly abdomen viscera and cut back difficulties in diagnostic and therapeutic accordingly .classical (open) ache –hospital hold—will enhance worth”and enhance morbidity 5%—25% (1).This study is aimed to guage price of laparoscopy in evaluation and remedy of acute abdomen. Therapeutic procedures like lap appendectomy ,drainage and lavage of fluids lap assisted resection and anastomosis is also carried out concurrently. Methods :-From 1-1-2014—-31-12”2017. The first 2years have been for assortment of data and remedy .the ultimate third 12 months have been restricted for adjust to up of the outcomes .An entire of 60 victims who've been admitted to the emergency division unit of Al-Hussein educating hospital underwent diagnostic laparoscopic examinations sooner than or in its place of therapeutic laparoscopic surgical procedures . sooner than operations for acute abdomen .The Victims have been investigated by US of abdomen X-Ray”and CT-scan of abdomen. The variables have been studied scientific attribute “form of surgical process—adjust to up assertion age”gender” scientific choices –form of pathology “form of surgical process”operative time —- analgesia requirement”hospitalizationperiod Outcomes :-acute abdomen is equally distributed between 2 genders male/FEMALE ratio 1:1.The age distribution confirmed that basically probably the most affected age group was ======== the most typical state of affairs seen was acute appendicitis (50%)of cases.it was usually accompanied by drainage of intraperitonial accumilates .lap. peptic perforations restore executed in ——-(15%)%of cases adhes olysis 6percentof cases . these surgical procedures usually accompanied by drainage of intraperitoneal accumilates . Enteric laparoscopic assisted open Surgical procedures approaches have been needed. Who picile 5% remodeled to open CLASSICAL LAPARATOMIES have been carried out . in whom in lap. assisted . And enteric perforation restore executed. In 5percentof cases lap steer clear of the affected individual any additional surgical procedures apart from diagnostic one. .Frequent time of lap. App was 48 minutes.——–% cases by which diagnostic lap have been discharge inside 2days.solely few cases need hold as a lot as 7days.as they've been lap. assisted open surgical procedures .——% of pat.by which we had carried out diagnostic . lap have been required solely single dose analgesia.—–%of victims lap analgesia for 1day and solely ——-%of victims need analgesia for 5 days in open lap. assisted surgical process executed.Dialogue :-ACUTE ABDOMEN IS EQUALLY DISTRIBUTED amongst every the gender . MORE frequent in age group from (15—45)years. higher than 90% belong to this group. ache present in all victims 96%.vomiting was the next optimistic indicators .pat ceaselessly complained of abdomen distension .Fever and constipation was moreover present in some cases .diarrhea was seen in few cases .abdomen tenderness is in almost all cases of acute abdomen .abdomen guardening was present and rigidity was there in most of cases .the most typical state of affairs is acute appendicitis.it was usually accompanied by drainage of free fluids .laparoscopic peptic perforation restore executed in ——%solely —–%of cases by which lap surgical procedures have been remodeled to open in whom —–%of cases —-%of cases lap assisted lower midline appendectomy and enteric perforation restore executed. lap assisted resection anastomosis. now after lap evaluation of acute appendicitis. with the equivalent incision single incision laparoscopic appendectomy .adhesolysis was moreover executed in considerable number of victims ,adhesolysis 2nd course of subsequent to ac appendicitis .adhesolysis and peptic perforation restore was moreover executed in considerable no. of victims.in few cases no pathology was recognized and solely drainage of fluids and lavage executed .most of pat which we had perform diagnostic laparoscopy have been discharge inside 2days .just some cases hold as a lot as 6days in whom laparoscopic assisted open laparotomy es required analgesia for 5days in whom lap assisted open surgical process executed. frequent time of performing solely diagnostic laparoscopy in 15 minutes and customary time of performing lap. Appendectomy was 48minutes. №‰Є№і”———laparatomy.minate good instrument in acute abdomen.ration restore have been executed in 2 victims . ———————-
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