XXXX : the use of diagnostic laparoscopy.

@entity1 @entity3509 @entity2679 @entity7140 @entity130
@entity7140 ( @entity7140 ) carries a high mortality in the critically ill @entity1 . This is partly due to the delay in its diagnosis. Clinical diagnostic examinations are often misleading. The purpose of our study was to evaluate the use of laparoscopy as a diagnostic tool in the evaluation of the critically ill @entity1 suspected of having @entity7140 . From May 1993 to January 1994, we evaluated 10 critically ill @entity1 . Mean age was 56 years (range 17-90 years). Nine of the @entity1 were @entity130 victims (8 blunt, 1 penetrating). The other @entity1 was postcoronary bypass surgery. The laparoscopy was done after a mean of 15 days (range 6-54 days) after ICU admission. All @entity1 were receiving ventilatory support, and all @entity1 had elevated temperatures of greater than 38.5 degrees C. Five @entity1 had abdominal tenderness, and 6 had elevated liver function tests (LFT). Six laparoscopies were done under local anesthesia and IV sedation at the bedside, and 4 were done in the operating room. All @entity1 tolerated the procedure well with no complications. The laparoscopic findings were @entity2679 in 2 @entity1 . They both underwent laparoscopic cholecystectomies in the operating room. We elected to drain a very distended gallbladder in 1 @entity1 , who eventually was found to have an @entity3509 of the chest. The other 7 examinations were normal. Six of these @entity1 recovered and were discharged. Our results suggest that laparoscopy can be used in the diagnosis of @entity7140 . Its positive and negative findings are valuable in the treatment of the critically ill. It can be done safely at the bedside.
