Can Patients with Appendicitis in Pregnancy be Operated in Secondary Hospital: A retrospective Study

Yıl 2018, Cilt: 8 Sayı: 1, 28 - 31, 28.06.2018

Adnan Budak Abdullah Şenlikçi Ramazan Güven

https://doi.org/10.17678/beuscitech.393202

Öz

Appendicitis is the most common non-obstetric
cause of acute abdomen in pregnancy. Diagnosis of appendicitis becomes difficult with the
change of appendiceal position during pregnancy. Late diagnosis and treatment
increase the likelihood of developing perforation. In this study, we aimed to evaluate perioperative outcomes of
appendicitis in pregnant patients in secondary hospitals in the light of the
literature. 29 pregnant
women who performed appendectomy between April 2012 and July 2017 were included
in the study. Patients were evaluated according to age, gestational age, white
blood cell count, percentage of neutrophil count, C-reactive protein level,
ultrasonographic findings, pathologic results, duration of hospitalization and
complications. Out of the 29 pregnant patients, 9 (31.0%) patients had surgery during the first trimester, 13
(44.8%) during the second trimester and 7 (24.2%) during the third trimester. Median
white blood cell count was 12870 K/mm³ (min-max;7170-25210).
Negative laparotomy rate was %31.0. Median duration of hospitalization was 3.24
days (2-7). Morbidity was observed in 2 (6.9%) of 29 patients. Intra-abdominal
abscess was observed in one patient and colonic fistula was observed in one
patient. Our results demonstrated that
appendectomy and follow-up of pregnant patients with acute appendicitis can be performed at secondary
hospitals.

Anahtar Kelimeler

Acute appendicitis; Appendectomy; Fetus; Pregnancy

Kaynakça

• [1] Franca Neto AH, Ramos do Amorm MM, Virgolina Nobreca BMS. Acute appendicitis in pregnancy: literature review. Rev Assoc Med Bras 2015; 61(2):170-7.[2] Wilasrusmee C, Sukrat B, McEvoy M, Attia J, Thakkinstian A. Systematic review and meta-analysis of safety of laparoscopic versus open appendicectomy for suspected appendicitis in pregnancy. British Journal of Surgery 2012; 99: 1470–1479.[3] Jung SJ, Lee DK, Kim JH, Kong PS, Kim KH, Ba SW. Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital. J Korean Soc Coloproctol 2012;28(3):152-9.[4] Arer IM, Alemdaroğlu S, Yeşilağaç H, Yabanoğlu H. Acute appendicitis during pregnancy: case series of 20 pregnant women. Ulus Travma Acil Cerrahi Derg 2016;22(16):545–8.[5] Ilhan E, Senlikci A, Kızanoglu H, Ustüner MA, Vardar E, Aykas A, Yeldan E, Yıldırım M. Do intestinal parasitic infestations in patients with clinically acute appendicitis increase the rate of negative laparotomy? Analysis of 3863 cases from Turkey. Przegląd Gastroenterologiczny 2013; 8 (6):366-9.[6] Kapan S, Bozkurt MA, Turhan AN, Gönenç M, Alış H. Management of acute appendicitis in pregnancy. Ulus Travma Acil Cerrahi Derg 2013;19:20–4.[7] Kazim SF, Inam Pal KM. Appendicitis in pregnancy: Experiance of thirty-eight patients diagnosed and managed at a tertiary care hospital in Karachi. International Journal of Surgery 2009;7:365–7.[8] Lurie S, Rahamim E, Piper I, Golan A, Sadan O. Total and differential leukocyte counts percentiles in normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2008;136(1):16-9.[9] Barth WH Jr, Goldberg JE. Acute appendicitis in pregnancy. Uptodate. [cited 2014 feb 28]. Available at: http://uptodate.com.[10] Yilmaz HG, Akgun Y, Bac B, Celik Y. Acute appendicitis in pregnancy- -risk factors associated with principal outcomes: a case control study. Int J Surg 2007;5:192–7.[11] Burcu B, Ekinci O, Atak T, Orhun K, Eren TT, Alimoglu O. Acute appendicitis in pregnancy: Case series and review. North Clin Istanbul 2016;3(1):60–3.[12] McGory MI, Zingmond DS, Tillou A, Hiatt RJ, Ko CY, Cryer HM. Negative appendectomy in pregnant women is associated with a substantial risk of fetal loss. J Am Coll Surg 2007;205:534-40.[13] Wieseler KM, Bhargava P, Kanal KM, Vaidya S, Stewart BK, Dighe MK. Imaging in pregnant patients: examination appropriateness. Radiographics 2010;30:1215-29.[14] Walker HGM, Samaraee AA, Mills SJ, Kalbassi MR. Laparoscopic appendicectomy in pregnancy: A systematic review of the published evidence. International Journal of Surgery 2014;12:1235-41.