Acute appendicitis during pregnancy: clinical experience

OBJECTIVE: Acute appendicitis is the most frequent nonobstetric disease which requires surgery during pregnancy. We intend to explicate 10 cases who get surgery due to acute apendicitis in our clinic.

METHODS: Clinical features of 10 pregnant patients admitted to our hospital between February 2009 - December 2012 were analyzed retrospectively
RESULTS: Abdominal pain was the reason for admission to hospital of 10 patients included in study. Abdominal pain was localized to right lower quadrant in our 9 patient, right upper quadrant in one patient with 32 week pregnancy. Abdominal ultrasound examination was performed to 8 patient preoperatively and 5 of them (%62.5) diagnosed as acute appendicitis. 3 patients who were not diagnosed as acute appendicitis by ultrasound imaging, got surgery due to pain in physical examination. Pathologic diagnosis was “appendicitis with inflammation and edema” in 7 patients and “appendicitis with necrosis and gangrene” in 1 patient. Pathologic diagnosis was normal in 2 patients who has not underwent ultrasonic examination.

CONCLUSION: We thought that even though acute appendicitis is difficult to diagnose during pregnancy, multidisciplinary aproach of surgeon, gynocologist and radiologist may decrease delay at treatment by the way decrease maternal and fetal motality and morbility rate.

Gebelerde akut apandisit: klinik deneyimimiz

AMAÇ: Gebelikte nonobstetrik nedenlerle en sýk cerrahi giriþim gerektiren cerrahi hastalýk akut apandisittir. Bizde kliniðimizde akut apandisit nedeniyle ameliyat ettiðimiz 10 vakayý literatür altýnda irdelemeyi amaçladýk.

YÖNTEMLER: Kliniðimizde Þubat 2009-Aralýk 2012 arasýnda apandektomi uygulanmýþ 10 gebe hastanýn bilgileri retrospektif olarak incelendi.

BULGULAR: Çalýþmaya alýnan 10 hastanýn hastanemize baþvuru nedeni karýn aðrýsý idi. 9 hastamýzda aðrý sað alt kadranda iken, 32 haftalýk gebeliði olan 1 hastada aðrý sað üst kadranda lokalize idi. 8 hastaya preoperatif dönemde ultrasonografi yapýldý ve 5’ine(%62.5) sonografik olarak akut apandisit tanýsý kondu. Ultrason incelenmesinin negatif olduðu 3 hasta ise fizik muayene bulgularýna göre ameliyat edildi. 7 hastada patoloji raporu ‘’Apendiks inflame, ödemli’’ 1 hastada ise ‘’Apendiks nekroze ve gangrene’’ olarak geldi. Ultrasonografi yapýlmayan 2 hastanýn patoloji sonucu ise normal olarak rapor edildi.

SONUÇ: Gebe hastalarda akut apandisit tanýsý zor olmakla beraber cerrah, jinekolog ve radyologlarýn multidisipliner yaklaþýmlarý tedavideki gecikmeleri, dolayýsýyla maternal ve fetal mortalite ve morbiditeyi azaltacaðý kanaatindeyiz.