Arer İlker Murat, Alemdaroğlu Songül, Yeşilağaç Hasan, Yabanoğlu Hakan
Department of General Surgery, Başkent University Adana Teaching and Research Center, Adana-Turkey.
Ulus Travma Acil Cerrahi Derg. 2016 Nov;22(6):545-548. doi: 10.5505/tjtes.2016.58458.
Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation.
Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study. Data were collected retrospectively. Patients were evaluated according to age, signs and symptoms, gestational age, physical findings, serum white blood cell count, ultrasound (US) findings, pathology reports, surgical technique, operation time, and complications.
Of 20 patients, 16 (80%) underwent open appendectomy and 4 (20%) underwent laparoscopic appendectomy. Mean age of patients was 29.6±5.6 years. Most common symptom was abdominal pain (95%). Six (30%) patients were in first trimester, 9 (45%) patients were in second trimester and 5 (25%) patients in were in third trimester. US findings consistent with AA were found in 12 (60%) patients. Negative appendectomy rate was 30%. Maternal complication was seen in only 1 (5%) patient. No fetal complication was observed.
Accurate diagnosis and prompt surgical treatment of AA in pregnant women should be performed due to high rates of maternal and fetal complications.
急性阑尾炎（AA）是孕期急腹症最常见的病因。然而，阑尾炎的多数体征在正常孕期也会出现，因此孕期阑尾炎的诊断仍具有挑战性。本研究的目的是报告我们在孕期急性阑尾炎方面的临床经验，并探讨针对这种困难情况的最佳处理方法。
本研究纳入了2005年至2015年间20例诊断为急性阑尾炎并接受阑尾切除术的孕妇记录。数据进行回顾性收集。根据年龄、体征和症状、孕周、体格检查结果、血清白细胞计数、超声（US）检查结果、病理报告、手术技术、手术时间及并发症对患者进行评估。
20例患者中，16例（80%）接受了开腹阑尾切除术，4例（20%）接受了腹腔镜阑尾切除术。患者的平均年龄为29.6±5.6岁。最常见的症状是腹痛（95%）。6例（30%）患者处于孕早期，9例（45%）患者处于孕中期，5例（25%）患者处于孕晚期。12例（60%）患者的超声检查结果符合急性阑尾炎表现。阴性阑尾切除率为30%。仅1例（5%）患者出现母体并发症。未观察到胎儿并发症。
由于孕产妇和胎儿并发症发生率较高，应对孕妇急性阑尾炎进行准确诊断并及时进行手术治疗。
