Burcu Busra, Ekinci Ozgur, Atak Tuba, Orhun Kivilcim, Eren Turgut Tunc, Alimoglu Orhan
Department of General Surgery, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
Department of General Surgery, Bursa Cekirge State Hospital, Bursa, Turkey.
North Clin Istanb. 2015 Oct 4;3(1):60-63. doi: 10.14744/nci.2015.96530. eCollection 2016.
Acute appendicitis is one of the most common acute surgical pathology we encountered. In this study we investigated our pregnant cases of appendicitis, and reviewed literature.
A total of 21 pregnant women who underwent appendectomy with the initial diagnosis of acute appendicitis in Istanbul Medeniyet University Clinics of General Surgery between January 2012, and December 2014 were retrospectively analyzed. The patients's ages, trimesters, complaints, abdominal examination, laboratory, and ultrasonographic findings, surgical techniques, complications and hospital stay were noted.
The patients were in their first (n=12; 57.1%), second (n=5; 23.8%), and third trimesters (n=4; 19.0%) of their pregnancies Median age was 23.9 years. All of the patients had abdominal pain. Median value of WBC count was 13.297/mm³. Ultrasound was positive in 12 patients (57.1%). In 14 (66.6%) patients McBurney incision, and in 6 (28.6%) cases right paramedian incision were used. One patient (4.8%) underwent laparoscopic appendectomy. Nineteen cases were acute appendicitis (90.5%), and two cases were perforated appendicitis (9.5%). Average hospital stay was 3.8 days. Two cases with perforated acute appendicitis developed wound infection and treated conservatively. There were no fetomaternal mortality.
Physiologically anatomic and biochemical changes occurring during pregnancy can delay the diagnosis of acute appendicitis threaten the lives of both the mother and the fetus Therefore, rapid diagnosis and appropriate treatment convey importance.
急性阑尾炎是我们最常遇到的急性外科疾病之一。在本研究中，我们调查了我院的妊娠合并阑尾炎病例，并复习相关文献。
回顾性分析2012年1月至2014年12月期间在伊斯坦布尔梅迪尼耶特大学普通外科门诊初次诊断为急性阑尾炎并行阑尾切除术的21例孕妇。记录患者的年龄、孕周、主诉、腹部检查、实验室检查、超声检查结果、手术方式、并发症及住院时间。
患者妊娠分别处于孕早期（n = 12；57.1%）、孕中期（n = 5；23.8%）和孕晚期（n = 4；19.0%），中位年龄为23.9岁。所有患者均有腹痛症状。白细胞计数中位数为13.297/mm³。12例（57.1%）超声检查阳性。14例（66.6%）采用麦氏切口，6例（28.6%）采用右侧旁正中切口。1例（4.8%）行腹腔镜阑尾切除术。19例为急性阑尾炎（90.5%），2例为穿孔性阑尾炎（9.5%）。平均住院时间为3.8天。2例穿孔性急性阑尾炎患者发生伤口感染，经保守治疗。无母婴死亡。
孕期发生的生理、解剖及生化改变可延误急性阑尾炎的诊断，威胁母婴生命，因此快速诊断及恰当治疗至关重要。
