Laparoscopic Evaluation in Chronic Post-operative Abdominal Pain

Maliheh Khosravi, MD, Amir Vejdan, MD

Imam Reza Hospital

Objective: Chronic post-operative abdominal pain especially after a heavy meal is a common problem in these patients. Approximately 20% of patientswith a history of laparotomy experience chronic post-prandial abdominal pain for months after operation. About 50% of them are referred to the health system for treatment. Most of the surgeons are not interested for a second operation in this condition, and prefer to follow conservative treatment. This study evaluates the cause of chronic post operative abdominal pain using diagnostic and therapeutic laparoscopic surgery.

Method and procedures: Elective laparoscopic surgery was performed on 76 patients suffering chronic abdominal pain mostly after heavy meal. They did not have any sign and symptom of acute intestinal obstruction and the most popular complaints were: abdominal pain in 100%, nausea in 30%, vomiting in 10%. Diagnostic laparoscopy was detected positive abdominal findings in 81% of patients. At the same operation, treatment modalities (laparoscopic enterloysis) were performed.

Results: In 81% of patients the cause of pain was intestinal adhesions due to adhesional bands. From the remaining, 10% had adhesions without any correlation to the patient’s symptoms. Adhesiolysis (sharp release with scissors) is the treatment of choice. 95% of those patients that underwent adhesiolysis became pain free for a mean average of 11 months fallow up (pre-operative average of pain episode was 4 time per week).

Conclusions: In a patient with post-prandial chronic abdominal pain and a history of previous laparotomy, diagnostic and therapeutic laparoscopic Adhesiolysis can be an effective method for treatment.

Session: Poster Presentation

Program Number: P478

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