Pregnancy problems: a case report
DOI:
https://doi.org/10.18203/2349-2902.isj20250147Keywords:
Deciduosis, Appendicitis, Pregnancy, Open appendicectomyAbstract
Appendicitis is a common surgical cause of abdominal pain. Investigation and diagnosis of the cause of right lower quadrant abdominal pain is more complex in women who are pregnant. A 27 year old, 34 week pregnant female presented with migratory RIF pain. Inflammatory markers were mildly elevated. There was a strong patient preference to avoid unnecessary. In this case we demonstrate the importance of keeping a broad differential diagnosis despite imaging findings. With a higher index of suspicion in this case surgery could potentially have been avoided. This could have avoided potential morbidity and additional psychosocial stress during the patient’s pregnancy. As such the limitations of diagnostic certainty with imaging especially less common modalities such as MRI should be appreciated.
Metrics
References
Hamill JK, Hill AG. A history of the treatment of appendicitis in children: lessons learned. ANZ J Surg. 2016;86(10):762-7. DOI: https://doi.org/10.1111/ans.13627
Nakashima M, Takeuchi M, Kawakami K. Clinical outcomes of acute appendicitis during pregnancy: Conservative management and appendectomy. World J Surg. 2021;45(6):1717-24. DOI: https://doi.org/10.1007/s00268-021-06010-w
D'Souza N, Hicks G, Beable R, Higginson A, Rud B. Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis. Cochrane Database Systemat Rev. 2021;12(12):CD012028. DOI: https://doi.org/10.1002/14651858.CD012028.pub2
Abhirami GR, Sathyavani C, Patil RN. Acute abdomen in pregnancy: a case series on clinical presentation and diagnostic dilemma. Int J Reproduct Contracept Obstetr Gynecol. 2021;10(2):742-6. DOI: https://doi.org/10.18203/2320-1770.ijrcog20210336
Zachariah SK, Fenn M, Jacob K, Arthungal SA, Zachariah SA. Management of acute abdomen in pregnancy: current perspectives. Int J Womens Health. 2019;11:119-34. DOI: https://doi.org/10.2147/IJWH.S151501
Spalluto LB, Woodfield CA, DeBenedectis CM, Lazarus E. MR imaging evaluation of abdominal pain during pregnancy: Appendicitis and other nonobstetric causes. Radiographics. 2012;32(3):705-17. DOI: https://doi.org/10.1148/rg.322115057
Bolat F, Canpolat T, Tarim E. Pregnancy-related peritoneal ectopic decidua (deciduosis): Morphological and clinical evaluation. Turk Patoloji Derg. 2012;28(1):56-60. DOI: https://doi.org/10.5146/tjpath.2012.01098
Smits L, Bockstal MV, Frezin J. Deciduosis of the appendix: a rare cause of acute abdomen during pregnancy (a case report). Pan Afr Med J. 2020;37:316. DOI: https://doi.org/10.11604/pamj.2020.37.316.26728
Ghannouchi M, Nacef K, Khlifa MB, Iyed K, Boudokhan M, Dhekra T, et al. Acute abdomen during pregnancy: appendicular deciduosis-a case report. J Surgical Case Rep. 2021;10:rjab477. DOI: https://doi.org/10.1093/jscr/rjab477
Kaneko M, Nozawa H, Rokutan H, Koji M, Tetsuo U, Soichiro I. Ectopic decidua of the appendix: a case report. Surg Case Rep. 2021;7:117. DOI: https://doi.org/10.1186/s40792-021-01204-9
Mathews BK, Fredrickson M, Sebasky M, Seymann G, Ramamoorthy S, Vilke G, et al. Structured case reviews for organizational learning about diagnostic vulnerabilities: initial experiences from two medical centers. Diagnosis (Berlin, Germany). 2020;7(1):27-35. DOI: https://doi.org/10.1515/dx-2019-0032
Downloads
Published
How to Cite
Issue
Section
