الفهرس 
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Abstract
Patients with acute abdominal pain constitute an essential number of surgical hospital admissions.1Those patients account about 50% of acute general surgical admissions.2 Nonspecific acute abdominal pain is a considerable problem in general surgery and accounts nearly 13% to 40% of emergency surgical hospital admissions for acute abdominal pain.3 Nonspecific acute abdominal pain is described as acute abdominal pain that persistence less than seven days and for which the diagnosis remains unknown after baseline investigation and diagnostic tools.1 To evaluate those patients, different strategies have been used including clinical observation, radiological investigation, and EL. In the presence of uncertainly, the watchful waiting choice is taken into consideration when the doctor is able to balance the current predicted advantage of immediate treatment versus the complications.4 When patients have non-typical signs, the option that is taken is ”wait and see” by hospitalizing them and performing frequent examinations. The predictive value of this method was estimated between 68-92%. This method may cause a harmful risk on the patient from complications such as peritonitis, hemorrhage, or infertility. However, if active measures are taken, laparotomy may be performed unnecessarily. With minimal invasive techniques, laparoscopy has become an option to diagnose and treat conditions with acute abdominal pain. The aim of this study was to assess the value of early laparoscopy versus active clinical observation in patients with nonspecific acute abdominal pain. This study included patients presented to the Mansoura emergency hospital with NSAP less than seven days Between January 2015 and April 2017. Among them, after medical examinations and baseline investigations, a total of 50 eligible patients have been randomized to either “early laparoscopy” (24 patients) or “active clinical observation” (26 patients. Laparoscope has both diagnostic and a therapeutic role in management of NSAP. Laparoscope, apart from being a good tool in diagnosis of NSAP, also extends the benefit of addressing the pathology at the same time. There is insufficient evidence to recommend routine use of EL as the gold standard in patients with NSAP. Conversely, there is no evidence of harm, or additional significant morbidity and mortality. Further large clinical trials are required to determine the role of laparoscopy in this clinical situation. laparoscopy improve diagnostic rate and decrease the hospital stay and reduce pain recurrence rate in comparison with OBS , and without adding any significant changes in morbidity and mortality in both groups.