Kulhan Mehmet, Kulhan Nur Gozde, Nayki Umit, Nayki Cenk, Ulug Pasa, Ata Nahit, Toklucu Hulya
Department of Gynecology and Obstetrics, Erzincan University, Turkey.
Ginekol Pol. 2017;88(3):147-150. doi: 10.5603/GP.a2017.0028.
Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester.
The study population consisted of 23 pregnant women who were diagnosed incidentally with appendicitis during cesarean at Erzincan University Hospital between 2015 and 2016.
Appendectomy was performed on 23 patients during a caesarean section performed for any reason. The mean dia-meter of appendix was 7.82 ± 1.85 mm. The mean operation time was 67.39 ± 18.94 SD and antibiotic therapy was given to all patients. Postoperative complications were noted in 4 (17.4%) patients. Wound infection was seen in 4 (17.4%) patients, the other 19 patients revealed no postoperative complications. The mean of APGAR score of newborns in the postoperative period was 8.26 ± 0.86 SD and no complications were observed in both mothers and newborns. Histopathology of the specimen confirmed acute appendicitis in 23 (100%) cases.
Acute appendicitis is a challenging diagnosis in the pregnant patient; however, early surgical intervention should be performed with any suspicion. The type of surgery depends on the surgeon's preference and experience.
阑尾炎是导致孕期非产科问题进行腹腔内手术的最常见病症，而孕期发生的生理和解剖学变化使阑尾炎的诊断变得复杂。尽管手术操作存在胎儿丢失或早产的风险，但诊断延迟也会增加母婴并发症的风险。在本报告中，我们介绍了我们的经验，并分析了孕晚期剖宫产术中偶然诊断出的阑尾炎的临床特征和妊娠结局。
研究对象为2015年至2016年期间在埃尔津詹大学医院剖宫产时偶然诊断为阑尾炎的23名孕妇。
23例患者在因任何原因进行剖宫产时接受了阑尾切除术。阑尾平均直径为7.82±1.85毫米。平均手术时间为67.39±18.94标准差，所有患者均接受了抗生素治疗。4例（17.4%）患者出现术后并发症。4例（17.4%）患者出现伤口感染，其他19例患者未出现术后并发症。术后新生儿阿氏评分平均为8.26±0.86标准差，母婴均未观察到并发症。标本的组织病理学证实23例（100%）为急性阑尾炎。
急性阑尾炎在孕妇中是一个具有挑战性的诊断；然而，一旦有任何怀疑，应尽早进行手术干预。手术方式取决于外科医生的偏好和经验。
