The role of laparoscopy in the intensive care unit

Evaluation of the abdomen in critically ill intensive care unit patients remains problematic. Sedation, neuromuscular blockade, and head injury frequently make physical examination unreliable. As intra-abdominal processes frequently contribute to the development of multiple organ failure, it is imperative to establish a diagnosis and initiate treatment as soon as possible while the organ failures remain reversible. A diagnostic algorithm is presented as well as a summary of recent literature that places diagnostic laparoscopy in context with other diagnostic studies for evaluation of the abdomen in this complex population of patients.