Chronic Abdominal Pain: Etiology and Clinical Features in a Laparoscopic Surgery Study

Background: Chronic abdominal pain is a persistent or intermittent discomfort in the abdominal region lasting for more than three months. It may be caused by various pathologies in different systems, including gastrointestinal, genitourinary, or gynecological, and can have either organic or functional origins. Despite the availability of advanced medical and surgical techniques, the role of diagnostic laparoscopy in evaluating chronic abdominal pain remains controversial. Method: A study was conducted to evaluate the sociodemographic profile, clinical features, and etiology of chronic abdominal pain in patients undergoing diagnostic laparoscopy. A pretested questionnaire was used to collect data on the patients’ age, gender, occupation, residence, socioeconomic status, and other relevant information. A detailed history and physical examination were performed, along with systemic examination to identify signs indicating an underlying etiology of abdominal pain. All patients underwent preoperative evaluations, including ultrasonography, erect abdominal X-ray, CT scan, MRI, and routine blood investigation, to identify the cause of their abdominal pain. Diagnostic laparoscopy was performed when the diagnosis was uncertain. Results: The study found that the mean age of patients with chronic abdominal pain was 38.99 ± 18.61 years, with the highest number of cases occurring in the 21 to 30 years age group, followed by those in the less than 20 and 31 to 40 years age groups. A small percentage of cases were found in patients aged over 70 years. Females accounted for 52.8% of cases, indicating a slight female predominance. The most commonly observed features in patients with chronic abdominal pain were free fluid, abdominal pain, weight loss, and anorexia. Vomiting and a doughy abdomen were less frequently observed. The study found that tuberculosis was the most common cause of chronic abdominal pain, accounting for 62.5% of cases, while malignancy was found in 30.6% of cases. A diagnosis could not be made in 6.9% of cases. The mean age of patients with tuberculosis was 29.93 ± 12.82 years, while those with malignancy had a mean age of 56.73 ± 14.02 years. The majority of cases of chronic abdominal pain associated with tuberculosis occurred in younger age groups, whereas a higher proportion of cases with malignancy were in elderly age groups. Conclusion: The study emphasizes the importance of diagnostic laparoscopy in managing chronic abdominal pain and reducing the financial burden on patients. It highlights the association of abdominal distension with malignancy and a doughy abdomen with tuberculosis. With advancements in surgical techniques and instrumentation, diagnostic laparoscopy has become an integral part of surgical procedures and can improve patient outcomes by avoiding expensive, time-consuming, and potentially complicated surgical procedures. Overall, this study provides valuable insights into the etiology and management of chronic abdominal pain.