Appendectomy for asymptomatic appendicitis during caesarean section - an interesting case report

Background: The authors present an interesting case report of an appendectomy during caesarean section in an asymptomatic pregnant woman, which highlights the need of peritoneal cavity check during every caesarean section. Materials and Methods: A 32-year-old para 0 woman at 34 weeks of gestation attended to the present clinic because of a feeling of reduced fetal movements in the last 24 hours. She underwent a non-stress test (NST), that was non-reassuring and no contractions were recorded. The woman underwent a caesarean section, which revealed a large phlegmonic appendix. Appendectomy was decided after the closure of the uterine cavity. Results: The woman was treated with appendectomy. Histology came back as an appendicitis three days later. Conclusions: Acute appendicitis during pregnancy may be associated with serious maternal and fetal complications. It is also associated with a high risk of premature delivery. In the absence of lower abdominal pain and inflammatory changes, the incidence of acute appendicitis is low, but exists. In every caesarean section at any week of gestation, we should check the peritoneal cavity and especially the appendix, as appendicitis is the most frequent non-obstetric surgical situation in pregnancy. Asymptomatic appendicitis should be considered as a cause in every pregnant woman who mentions preterm contractions or/and reduced fetal movements.