Diagnostic laparoscopy for suspected XXXX .

@entity1 @entity32 @entity698 @entity2466 @entity733 @entity490 @entity130
One hundred consecutive @entity1 who underwent diagnostic laparoscopy for suspected @entity698 were evaluated to assess the appropriate clinical setting for laparoscopic appendectomy. The usefulness of diagnostic laparoscopy in the setting of acute @entity490 has been well documented. However, there is debate about the use of laparoscopy for definitive therapy. The purpose of this study is to evaluate the decision making process during diagnostic laparoscopy for suspected @entity698 . When pathology is identified other than in the appendix, the majority of @entity1 can be treated without converting to an open procedure. In @entity1 found to have no obvious pathology, incidental appendectomy can be performed laparoscopically. When @entity698 was identified, the majority of @entity1 could be treated safely without converting to an open technique. However, there were certain clinical situations that necessitated conversion to an open operation. Involvement of the cecum or perforation at the base of the appendix puts the @entity2466 at risk for leak and @entity733 formation. Evaluation of the cecum by palpation for a mass should also be performed in this situation. Another situation in which conversion to an open technique is warranted is an @entity2466 with adherent small bowel. The friability of bowel wall greatly increases the risk for @entity130 in this setting. Laparoscopy is a useful technique for the diagnosis and treatment of @entity490 even if the appendix is normal on inspection. Conversion to an open operation should be employed when @entity32 or perforation occurs at the base of the appendix and when bowel is found to be adherent to an @entity2466 .
