Acute appendicitis in pregnancy: literature review.

被引:58
作者
de Franca Neto, Antonio Henriques [1 ]
Ramos do Amorim, Melania Maria [2 ]
Virgolino Nobrega, Bianca Maria Souza
机构
[1] Univ Fed Campine Grande, PRM, Ginecol & Obstetr, Campina Grande, PB, Brazil
[2] Univ Fed Campine Grande, Discipline Ginecol, Campina Grande, PB, Brazil
来源
REVISTA DA ASSOCIACAO MEDICA BRASILEIRA | 2015年 / 61卷 / 02期
关键词
appendicitis; pregnancy; pregnancy complications; LAPAROSCOPIC APPENDECTOMY; SUSPECTED APPENDICITIS; COMPUTED-TOMOGRAPHY; 3RD TRIMESTER; NEGATIVE APPENDECTOMY; LEUKOCYTE COUNTS; ACUTE ABDOMEN; DIAGNOSIS; MANAGEMENT; WOMEN;
D O I
10.1590/1806-9282.61.02.170
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms "acute appendicitis" and "pregnancy", in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases. Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MM may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video-assisted surgery in these cases remains controversial.
引用
收藏
页码:170 / 177
页数:8
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