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Abstract
Laparoscopy has many applications in acute abdomen, due to diverse etiologies of acute abdomen including those that can be managed medically. It has a great value in diagnosis of etiology of acute abdomen, in differentiation between the causes that need exploration and the causes that need medical treatment, especially in cases that we will wait and see or investigate and see. It is used after other investigation modalities as ultrasound or CT.
It’s used in treatment of acute appendicitis, acute cholecystitis, empyema of gall bladder, mucocele of gall bladder, removal of intestinal adhesions in intestinal obstruction, in acute diverticulitis, and in removal of the segment of intestine affected by Crohn’s disease presented by intestinal obstruction. It can be used in intestinal ischemia to diagnose it with certain precautions and to resect the gangrenous segment if presented in addition to removal of Meckel’s diverticulum.
To use laparoscopy for therapeutic purposes in acute abdomen, it’s preferred for patients having localized infection which didn’t reach the diffuse peritonitis stage. Other relative contraindications are very obese patients who have much intraperitoneal fat that makes dissection difficult or delayed cases after 48 of the onset of acute abdomen that may have a phlegmon obscuring the field and pregnant females according to surgeon’s talent and experience. Coagulopathy is an absolute contraindication for laparoscopy.