Analysis of diagnostic laparoscopy and imaging studies for the handling of pain in undetermined etiology right iliac fossa

Abstract

Introduction:

right iliac fossa (RIF) pain is a frequent reason for consultation at the Emergency Units. The main challenge lies in defining whether it is a surgical condition or not.

Objective:

to learn about the role of diagnostic laparoscopy, abdominal ultrasound and CT scan in the studies algorithm of patients with RIF pain of unknown etiology in Uruguay.

Method:

observational, descriptive, prospective, multi-center study of patients who consulted for RIF from June 1st to August 31, 2017 in Health Institutions in Uruguay. The following data were gathered in an excel sheet: sex, age, symptoms, physical findings, tests requested, conduct adopted, intraoperative findings and complications.

Results:

159 sheets were completed. Upon a primary assessment a diagnostic doubt was arose in 69 patients (43.4%). A CT scan was requested to 29 patients, and a CT was performed to 78% of patients older than 50 years old vs 18% of those between 15 and 29 years.

Conclusions:

the diagnostic laparoscopy allowed for diagnosis in most cases. Sensitivity of the CT scan was low when compared to international data. The diagnostic algorithm needs to me individualized, based on protocols adapted to the resources of every institution.