Appendicitis during Pregnancy in Dumnersaduak Hospital between 1994-2009
Keywords:
Appendicitis, Graded compression ultrasonographyAbstract
This was a 15 years retrospective study of appendicitis during pregnancy in Dumnernsasuak hospital between 1994 - 2009. There were eighteen patients. The gestational stage at diagnosis were first, second, third trimester and post partum period accounted for 33.33, 50, 11.11 and 5.56 percent respectively. The clinical sings of these patients were fever nausea vomiting, diarrhea, dysuria, rectal or vaginal pain and vaginal bleeding accounted for 11.11, 83.33, 5.56, 11.11, 5.56 and 5.56 percent respectively.
All patients had abdominal pain that present with right lower quadrant, right frank and right upper quadrant pain, accounted for 77.77, 16.67 and 5.56 percent respectively. Rebound tender and guarding were 83.30 and 5.56 percent respectively. Leukocytosis > 10,000 cell/ml. was 94.44 percent. Neutrophilia > 80% was 89 percent ant the success rate of ultrasonography was 78.5 percent. All patients were operated within 24 hours of admission without serious complications. There were normal vaginal delivery 83.33 percent and premature delivery 5.56 percent. One patient was delivered by cesarean section with obstetric indication. All new babies were healthy.
References
Mourad J, Elliott JP, Erickson L, Lisboa L. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Am J Obstet Gynecol. 2000;182(5):1027-9. doi:10.1067/mob.2000.105396.
Babaknia A, Parsa H, Woodruff JD. Appendicitis during pregnancy. Obstet Gynecol. 1977;50(1):40-4.
Baer JL, Reis RA, Arens RA. Appendicitis in pregnancy with changes in position and axis of the normal appendix in pregnancy. JAMA 1932;98:1359-64.
Andersson RE, Lambe M. Incidence of appendicitis during pregnancy. Int J Epidemiol. 2001;30(6):1281-5. doi:10.1093/ije/30.6.1281.
Hodjati H, Kazerooni T. Location of the appendix in the gravid patient: a re-evaluation of the established concept. Int J Gynaecol Obstet. 2003;81(3):245-7. doi:10.1016/s0020-7292(03)00074-2.
Sharp HT. Gastrointestinal surgical conditions during pregnancy. Clin Obstet Gynecol. 1994;37(2):306-15. doi:10.1097/00003081-199406000-00008.
Jeffrey RB Jr, Laing FC, Lewis FR. Acute appendicitis: high-resolution real-time US findings. Radiology. 1987;163(1):11-4.doi:10.1148/radiology.163.1.3547490.
Puylaert JB. Acute appendicitis: US evaluation using graded compression. Radiology. 1986;158(2):355-60. doi:10.1148/radiology.158.2.2934762.
Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol. 1992;159(3):539-42. doi:10.2214/ajr.159.3.1503019.
Tamir IL, Bongard FS, Klein SR. Acute appendicitis in the pregnant patient. Am J Surg. 1990;160(6):571-5; discussion 575-6. doi:10.1016/s0002-9610(05)80748-2.
Popkin CA, Lopez PP, Cohn SM, Brown M, Lynn M. The incision of choice for pregnant women with appendicitis is through McBurney's point. Am J Surg. 2002;183(1):20-2. doi:10.1016/s0002-9610(01)00842-x.
de Veciana M, Towers CV, Major CA, Lien JM, Toohey JS. Pulmonary injury associated with appendicitis in pregnancy: who is at risk? Am J Obstet Gynecol. 1994;171(4):1008-13. doi:10.1016/0002-9378(94)90024-8.
Paulson EK, Kalady MF, Pappas TN. Clinical practice. Suspected appendicitis. N Engl J Med. 2003;348(3):236-42. doi:10.1056/NEJMcp013351.