Gebelerde akut apandisit: klinik deneyimimiz

Öz

AMAÇ: Gebelikte nonobstetrik nedenlerle en sık cerrahi girişim gerektiren cerrahi hastalık akut apandisittir. Bizde kliniğimizde akut apandisit nedeniyle ameliyat ettiğimiz 10 vakayı literatür altında irdelemeyi amaçladık.YÖNTEMLER: Kliniğimizde Şubat 2009-Aralık 2012 arasında apandektomi uygulanmış 10 gebe hastanın bilgileri retrospektif olarak incelendi.BULGULAR: Çalışmaya alınan 10 hastanın hastanemize başvuru nedeni karın ağrısı idi. 9 hastamızda ağrı sağ alt kadranda iken, 32 haftalık gebeliği olan 1 hastada ağrı sağ üst kadranda lokalize idi. 8 hastaya preoperatif dönemde ultrasonografi yapıldı ve 5’ine(%62.5) sonografik olarak akut apandisit tanısı kondu. Ultrason incelenmesinin negatif olduğu 3 hasta ise fizik muayene bulgularına göre ameliyat edildi. 7 hastada patoloji raporu ‘’Apendiks inflame, ödemli’’ 1 hastada ise ‘’Apendiks nekroze ve gangrene’’ olarak geldi. Ultrasonografi yapılmayan 2 hastanın patoloji sonucu ise normal olarak rapor edildi.SONUÇ: Gebe hastalarda akut apandisit tanısı zor olmakla beraber cerrah, jinekolog ve radyologların multidisipliner yaklaşımları tedavideki gecikmeleri, dolayısıyla maternal ve fetal mortalite ve morbiditeyi azaltacağı kanaatindeyiz.

Anahtar Kelimeler

• gebelik, akut apandisit

Acute appendicitis during pregnancy: clinical experience

Abstract

OBJECTIVE: Acute appendicitis is the most frequent nonobstetric disease which requires surgery during pregnancy. We intend to explicate 10 cases who get surgery due to acute apendicitis in our clinic.METHODS: Clinical features of 10 pregnant patients admitted to our hospital between February 2009 - December 2012 were analyzed retrospectivelyRESULTS: Abdominal pain was the reason for admission to hospital of 10 patients included in study. Abdominal pain was localized to right lower quadrant in our 9 patient, right upper quadrant in one patient with 32 week pregnancy. Abdominal ultrasound examination was performed to 8 patient preoperatively and 5 of them (%62.5) diagnosed as acute appendicitis. 3 patients who were not diagnosed as acute appendicitis by ultrasound imaging, got surgery due to pain in physical examination. Pathologic diagnosis was “appendicitis with inflammation and edema” in 7 patients and “appendicitis with necrosis and gangrene” in 1 patient. Pathologic diagnosis was normal in 2 patients who has not underwent ultrasonic examination. CONCLUSION: We thought that even though acute appendicitis is difficult to diagnose during pregnancy, multidisciplinary aproach of surgeon, gynocologist and radiologist may decrease delay at treatment by the way decrease maternal and fetal motality and morbility rate.

Keywords

• Pregnancy, acute appendicitis