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Laparoscopy for diagnosis and treatment of recurrent abdominal pain in children.

Abstract
Extensive radiographic evaluation of children with recurrent abdominal pain (RAP) is rarely diagnostic or cost-effective. The authors sought to define the role of laparoscopy in the evaluation of children with RAP. Fifteen children underwent laparoscopy for RAP in a 2-year period. Their mean age was 12 years (range, 6 to 16 years), 13 (87%) were female, and the mean duration of symptoms was 11 months (range, 2 to 60 months). Thirty-eight imaging studies (excluding plain films) had been obtained before laparoscopy, including 19 abdominal sonograms, 9 upper gastrointestinal series, four abdominal computed tomography scans, 3 barium enemas, 2 isotope scans, and 1 magnetic resonance examination of the head. Only two (5%) of these studies provided an accurate diagnosis. Eleven of the 15 children (73%) had positive findings diagnosed and treated laparoscopically. These included eight appendiceal abnormalities (in six patients), three Meckel's diverticula, one inguinal hernia, one urachal cyst, one para-fallopian tube cyst, and one adhesion to an appendectomy stump. Eight of 11 (73%) children with positive findings had immediate resolution of symptoms after laparoscopic treatment. Three children with pathological findings at the time of laparoscopy had persistent symptoms, which resolved completely within 4 months of the laparoscopy. Laparoscopy is an accurate technique for the evaluation and treatment of children with RAP. Its early application could provide economic benefit by eliminating many low-yield imaging studies and minimizing lost time from school.
AuthorsS Stylianos, J E Stein, L M Flanigan, D H Hechtman
JournalJournal of pediatric surgery (J Pediatr Surg) Vol. 31 Issue 8 Pg. 1158-60 (Aug 1996) ISSN: 0022-3468 [Print] UNITED STATES
PMID8863255 (Publication Type: Journal Article)
Topics
  • Abdominal Pain (diagnosis, etiology, surgery)
  • Adolescent
  • Child
  • Cost-Benefit Analysis
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy (economics)
  • Male
  • Recurrence
  • Reproducibility of Results
  • Treatment Outcome

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