PMID: 2947659Dec 1, 1986Paper

Laparoscopy as an adjunct to decision making in the 'acute abdomen'

The British Journal of Surgery
S Paterson-BrownH A Dudley


When patients are admitted to hospital with acute abdominal pain, clinicians, irrespective of a specific diagnosis, intuitively select three diagnostic classes: operation definitely required (Group A); operation definitely not required (Group B); need for operation uncertain (Group C). The last is followed either by a precautionary laparotomy or a variable period of observation/investigation. We have studied prospectively the influence of laparoscopy on the distribution between these classes and particularly on outcome in group C. One hundred and twenty-five consecutive patients with abdominal pain severe enough for emergency admission have been classified by one of two admitting surgeons (SHO/registrar), who also expressed in group C a view on how they would proceed--operation or observation. Group C were then laparoscoped. The procedure confirmed a provisional view that laparotomy was needed in 11 of 15 patients. In the 'observation' sub-group the provisional decision was confirmed in 14 of 16 and early discharge followed in most. Six inappropriate decisions were thus avoided. Seven management decisions in group A and 4 in group B proved incorrect (11/94: 12 per cent). The majority were potentially recognizable by laparoscopy...Continue Reading


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Nov 2, 1991·BMJ : British Medical Journal·S Paterson-Brown
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Oct 1, 1989·The British Journal of Surgery·S Paterson-BrownH A Dudley
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Apr 1, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Mustafa AtesMahmut Bulbul
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Nov 1, 1989·The British Journal of Surgery·T T Irvin
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Related Concepts

Abdomen, Acute
Computer Assisted Diagnosis
Surgical Procedures, Laparoscopic
Patient Referral

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