Zapletal Jan, Sehnal Borek, Drochytek Vit, Hruda Martin, Lochmanova Ivana, Halaska Michael J, Oliverius Martin
Department of Obstetrics and Gynaecology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Department of Surgery, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Visc Med. 2025 Apr;41(2):86-91. doi: 10.1159/000543297. Epub 2024 Dec 30.
Appendectomy for acute appendicitis is the most common surgical procedure performed during pregnancy. The primary treatment for acute appendicitis is emergency surgery, which can be particularly challenging due to altered anatomical conditions. Preoperative and postoperative care may require certain examinations due to pregnancy that are not standard within surgical practice or may be overlooked by the attending gynecologist.
A patient at 31 weeks of gestation presented to the obstetric clinic with an acute onset of acute appendicitis. After completing all necessary examinations and a thorough multidisciplinary evaluation, a successful laparoscopic appendectomy was performed. The subsequent hospitalization was complicated by the onset of uterine contractions, for which tocolysis was administered in combination with corticosteroid therapy to induce fetal lung maturity.
In the presented case report, we demonstrate an example of the appropriate multidisciplinary approach with an analysis of the specific steps that should be taken to maximize the benefit for both the fetus and the mother, as well as the surgical team. In the discussion, we outline the steps that should be followed for patient benefit and forensic reasons.
妊娠期急性阑尾炎行阑尾切除术是孕期最常见的外科手术。急性阑尾炎的主要治疗方法是急诊手术,由于解剖结构改变,这可能极具挑战性。由于妊娠,术前和术后护理可能需要进行一些手术实践中不标准或可能被主治妇科医生忽视的特定检查。
一名妊娠31周的患者因急性阑尾炎急性发作就诊于产科门诊。在完成所有必要检查和全面的多学科评估后,成功进行了腹腔镜阑尾切除术。随后的住院期间出现了子宫收缩并发症,为此采用了宫缩抑制剂联合皮质类固醇疗法以促进胎儿肺成熟。
在本病例报告中,我们展示了一个适当的多学科方法示例,分析了为使胎儿、母亲以及手术团队获得最大益处应采取的具体步骤。在讨论中,我们概述了出于患者利益和法医原因应遵循的步骤。