Difficult to diagnose abdominal pain is a challenge in the daily routine of surgeons, however,
with the popularization of access to laparoendoscopy, the surgeon has acquired another piece
of the diagnostic arsenal, this one with the benefit of having a therapeutic nature. This paper
aims to report the case of a patient who was admitted to the Unimed Hospital in Palmas -
Tocantins, with acute abdominal pain difficult to diagnose, in which diagnostic laparoscopy
was essential for detecting and surgically treating the cause. In the case report, a 22-year-old
male patient presented with acute abdominal pain in the right flank and right iliac fossa, with
a 7-day evolution and associated with anorexia, asthenia and prostration. No changes in
laboratory tests. Computed tomography performed showed mild peritoneal thickening in the
right flank and right iliac fossa. The patient was surgically approached laparoscopically,
where a tumor in the parietal peritoneum was identified on the right flank, which was duly
resected. The anatomopathological study identified the tumor as a necrotic lipoma. Acute
abdomen is usually a very common surgical emergency that, if ignored, can lead to death. The
patient in question, despite not having presented a classic clinic, had his abdominal pain
complaint duly valued, thus avoiding an unfavorable evolution with a worse prognosis,
demonstrating the importance of diagnostic laparoscopy in the management of patients with
nonspecific abdominal pain.
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