Acute appendicitis in pregnancy mimicking leiomyoma pain

Acute appendicitis is the most common nonobstetric condition requiring surgery in pregnancy. However, the diagnosis of acute appendicitis during pregnancy is challenging because of obscure clinical manifestations and laboratory findings. Intravenous antibiotic treatment is not preferred over operation because of the poor outcome. Here, we present a case of a 34-year-old woman in the second trimester of pregnancy who presented with suprapubic pain and an unexpected 3.5 cm-long exophytic intramural myoma on the right anterolateral wall of the uterus rather than prominent appendicitis features; thus, it took 2 days to confirm the diagnosis. Laparoscopic appendectomy was performed, and the patient was discharged without lingering reports on postoperative day 6. Acute appendicitis during pregnancy is common; therefore, attentive clinical suspicion will contribute to shorter hospital stays as well as fewer maternal and fetal complications.