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Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Kontopodis N., Kouraki At., Miliadis O., Volakakis J., Psarakis F., Spiridakis K.
First Surgical Department, Venizeleio-Pananeio General Hospital of Heraklion, Crete, Greece
AIM: Acute appendicitis is the most common non obstetric cause of acute abdominal pain in pregnant patients. Physiologic changes during pregnancy may alter clinical presentation and obscure diagnosis. Delayed diagnosis and treatment leads to increased rates of maternal and fetal mortality. We reviewed the appendicities during pregnancy we came along during a two years period. The aim of our study was to compare parameters such as clinical presentation, pathological findings and surgical results in terms of total hospital stay and time until definite trauma closure to those of general population.
METHODS: During two years time, from September 2009 to August 2011, we managed 88 patients suffering from appendicitis in our department. 5 of these patients were pregnant. After the diagnosis was established by clinical examination, laboratory findings and imaging techniques, all patients underwent appendectomy.
RESULTS: Clinical presentation of appendicitis was found to be different during pregnancy. Although abdominal pain was present in all pregnant and non pregnant patients nausea and vomiting were much more common during pregnancy while anorexia that is found almost universally in general population was present only in 40% during pregnancy. Right upper quadrant tenderness and minimal peritoneal irrigation were common in pregnant patients. Higher rates of perforation occur during pregnancy. Longer times of hospitalization were required in pregnant patients compared to general population (9.6 days vs. 6.15 days) as well as time until definite trauma closure (14 days vs. 12.1 days).
CONCLUSION: Early diagnosis of acute appendicitis is essential to avoid perforation that leads to increased hospital stay, delayed trauma closure and complications such as maternal and fetal mortality.