الفهرس 
8.Peptic ulcerOnly 14 pages are availabe for public view
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Abstract
Chronic abdominal pain is a difficult complaint. It leads to evident suffering and disability, both physically and physiologically.It is associated with poor quality of life and significant levels of depressive symptoms. Much is known about the prevalence, societal burdens, and suffering associated with chronic abdominal pain. (Gouda and Emad 2010);Camilleri 2006); Ferrell 1995);Magni et al, 1992)
Chronic abdominal pain is common disorder in general practice and in hospitals. Although patients with this type of pain may undergone numerous diagnostic workups, including surgery, their pain remain a challenge to all known diagnostic and treatment methods. After all more than 40% of the patients presenting with chronic abdominal pain had no specific etiological diagnosis at the end of their diagnostic workup (Paajanen et al, 2005)
Many common organic and functional diseases can cause it. The most common organic condition includes intestinal adhesions(Peters and Van Den Tillaart 2007);Van Goor 2007), biliary causes(Dumont and Caniano 1999); Johnson 2001) and appendicular causes(Fayez et al, 1995). While functional conditions include irritable bowel diseases(Mertz 2003), functional dyspepsia(Tack and Lee 2005) and various motility disorders(Abell and Werkman 1996) . Abdominal wall pain is common and frequently mistaken for visceral pain.( Lindsetmo and Stulberg 2009);Costanza 2004), After ruling out common diseases by careful investigations, many patients are still undiagnosed and represent a major diagnostic challenge to the surgeon. (Galili et al, 2009)
With the introduction of laparoscopic surgery, a new tool has been added to our knowledge. The use of this new technology in the diagnosis and management of chroni abdominal pain has been tried in previous studies. ( Salky and Edye 1998) ; Klingensmith et al, 1996); Mueller et al, 1995)
Laparoscopy can identify abnormal findings and improve the outcome in a majority of patients with chronic abdominal pain, as it allow the surgeon to see and treat many abdominal conditions that cannot be diagnosed otherwise. (Paajanen et al, 2005) ; Kingensmith et al, 1996))
It is a safe and effective tool and can establish the etiology and allow for the appropriate intervention in such cases. (Onders and Mittendorf 2003)
Abdominal adhesions are the most likely findings, especially in a patient with a past history of abdominal operations. Other findings such as appendiceal pathology, hepatobiliary causes and endometriosis can be discovered and dealt with. (Szomestin et al, 2006) ; Salky and Edye 1998)
Major abdominal operations result in random and unpredictable intraabdomial scar tissue formation. Intraabdomial scar tissue may result in chronic abdominal pain, recurrent episodes of bowel obstruction or both. Laparoscopic adhesolysis may provide relief of symptoms in patients with prior abdominal surgery with chromic abdominal pain. (Vafa et al, 2002)
However some author denies the value of laparoscopy in adhesolysis and considers it controversial and not evidence based and therefore do not recommend it as a treatment for adhesions in patients with chronic abdominal pain. (Ikrad 1992) ; swank et al, 2003) Other authors says it is a safe and effective management option for patients with prior abdominal surgery for chronic abdominal pain or recurrent bowel obstruction. (Vafa et al, 2002)