APPENDICITIS IN PREGNANCY
Diagnosis appendicitis in pregnancy is challenging task for all surgeon.
Features such as nausea and vomiting may be thought to be those normally seen with pregnancy, and abdominal pain may be thought to be due to false labor or Braxton Hicks contractions.Even laboratory findings of elevated white blood cells in acute appendicitis occurs in normal pregnancy.The typical sign of appendicitis mc-Burney tenderness is not seen in pregnancy.As the uterus gets bigger, it pushes the appendix upwards towards the right kidney. This causes the pain expected down in the lower right abdomen to be in the flank or even on the back. Thus the patient may be suspected of having right kidney infection, instead of appendicitis. Any pregnant woman with pain on the right side of the abdomen should therefore be scanned for a possible appendicitis….otherwise it could be fatal for both mother and baby………………….
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Filed Under: General
“Physical examination is the most reliable tool for diagnosis” (Am Surg 2000 Jun;66(6):555-9)
Tenderness – RLQ
Rebound & Guarding (peritoneal signs)
Rovsing sign
Dunphy’s sign
Psoas sign (retroperitoneal retrocecal appendix)
Obturator sign (pelvic appendix)
Rectal examination tenderness (cul-de-sac)
Low grade fever
+Imaging:
KUB
Barium enema
Graded compression ultrasonography
Helical CT scan