[Diagnostic and therapeutic usefulness of laparoscopic surgery in acute abdomen of gynecologic origin]

Abstract

The objective was to determine the usefulness of laparoscopy for treatment of gynecological emergencies. In this work were studied 78 cases of patients which were treated in the Emergency Room of ABC Hospital, with symptomatology associated to reproductive organs. The age of patients was 27.7 +/- 6.3 years. The more frequent diagnosis before surgery were ectopic pregnancy and ovarian cysts, the remainder patients were operated to determine pain etiology. Ectopic pregnancy antecedent was determinant to have same problem (X2, p < 0.05), other determinative factors were infertility and pelvic inflammatory disease. Abdominal pathology was detected in 97.4% of patients; 98.6% with gynecological pathology. The predictive positive value of preoperative diagnosis was 83.3% and 91.3% for ectopic pregnancy and ovarian cysts, respectively. In 25.6% of the cases endoscopy turned in laparotomy; massive hemoperitoneum in tubal rupture in cases of ectopic pregnancy was the most frequent indication of this conduct. As conclusion, laparoscopy is useful in most of cases of gynecological emergencies. Fast detection or abdominal pathology, in special ectopic pregnancy can be to lower conversion of laparoscopy to open surgery.