Saleh Mona, Kim Antonia Francis, Gardner Andrew, Sun Katherine, Brubaker Sara
Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York.
Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey.
AJP Rep. 2020 Apr;10(2):e129-e132. doi: 10.1055/s-0040-1708849. Epub 2020 Apr 15.
Appendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case.
妊娠期阑尾炎是最常见的非产科外科急症。妊娠会引起解剖结构的改变，这可能导致阑尾炎诊断的不确定性。本病例报告描述了一例妊娠中期孕妇出现腹膜阴道瘘的阑尾炎病例，病理检查发现孤立性阑尾子宫内膜异位症，这一发现很有意思。对于出现急性腹痛的孕妇，强调包括阴道窥器检查在内的全面体格检查的重要性。诊断阑尾炎的影像学标准应根据妊娠子宫进行调整，妊娠子宫可能导致阑尾脓肿出现在各种位置，如本例中的宫颈后方。
