Kannan, G (2016) A study on the role of elective laparoscopic appendectomy for chronic right lower quadrant pain. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Chronic right lower quadrant abdominal pain(RLQ) is common clinical entity and continues to remain a diagnostic and therapeutic problem. Although the typical presentation of acute appendicitis is well known, there is a debate whether the so called chronic or recurrent appendicitis may cause persistent or recurrent pain in the RLQ. Chronic RLQ pain causes disability and distress and causes significant cost to health services . Laparoscopic is changing the view regarding exploration in patients with right lower quadrant AIMS AND OBJECTIVES: 1. To study the role of elective laparoscopic appendectomy for chronic or recurrent right lower quadrant pain . 2. To stydy the relationship between clinical improvement and histopathological Findings of removed appendix. METHODOLOGY: An observational study was done in Institute of surgery, Rajiv Gandhi government Hospital ,Chennai between jan 2014 to 2015. All 50 patients with chronic or recurrent right lower quadrant pain for more than 3 months in whom routine investigations ,radiological investigations didn’t reveal any pathology. Those patients subjected to laparoscopic appendectomy, then patients followed after 6 weeks and 3 months of interval. The primary outcome measure was by pain scored by the patient ,secondary outcome was relationship between clinical improvement and histopathological findings of removed appendix. RESULTS : In our study .it shows that 40 (80%)had complete relief of RLQ pain after 6 weeks ,and at the end of 3 months 45(90%) patients had complete relief of pain but still 5(10%) patients complained of RLQ abdominal pain. In our study 26(52%) patients are female and 24(48%)patients are male, the age group with maximum no of cases with chronic or recurrent RLQ pain was 21- 30 years. The histopathological results for all 50 patients ,14 patients (28%) had chronic appendicitis,12 patients (24%)had features of acute appendicitis and 24 patients (48%) had normal features. In our study no post op complications or post op deaths were encountered.. CONCLUSION: In patients with chronic right lower quadrant abdominal pain, elective laparoscopic appendectomy could be an effective therapeutic procedure in properly selected patients. Histopathological findings of removed appendix does not contribute in establishing the diagnosis in these patients.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Chronic right lower quadrant pain (RLQ); Chronic appendicitis ; Laparoscopic appendicectomy. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 27 Sep 2017 01:21 |
| Last Modified: | 27 Sep 2017 01:21 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3369 |
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