Appendicitis in Pregnancy: A Multidisciplinary Approach and Optimal Management from the Perspective of Gynecology and Obstetrics - A Case Report.

IF 1.6 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Visceral Medicine Pub Date : 2025-04-01 Epub Date: 2024-12-30 DOI:10.1159/000543297
Jan Zapletal, Borek Sehnal, Vit Drochytek, Martin Hruda, Ivana Lochmanova, Michael J Halaska, Martin Oliverius
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Abstract

Introduction: Appendectomy for acute appendicitis is the most common surgical procedure performed during pregnancy. The primary treatment for acute appendicitis is emergency surgery, which can be particularly challenging due to altered anatomical conditions. Preoperative and postoperative care may require certain examinations due to pregnancy that are not standard within surgical practice or may be overlooked by the attending gynecologist.

Case presentation: A patient at 31 weeks of gestation presented to the obstetric clinic with an acute onset of acute appendicitis. After completing all necessary examinations and a thorough multidisciplinary evaluation, a successful laparoscopic appendectomy was performed. The subsequent hospitalization was complicated by the onset of uterine contractions, for which tocolysis was administered in combination with corticosteroid therapy to induce fetal lung maturity.

Conclusion: In the presented case report, we demonstrate an example of the appropriate multidisciplinary approach with an analysis of the specific steps that should be taken to maximize the benefit for both the fetus and the mother, as well as the surgical team. In the discussion, we outline the steps that should be followed for patient benefit and forensic reasons.

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妊娠阑尾炎:从妇产科角度的多学科方法和最佳管理- 1例报告。
导言急性阑尾炎的阑尾切除术是孕期最常见的外科手术。急性阑尾炎的主要治疗方法是急诊手术,由于解剖条件的改变,这种手术尤其具有挑战性。由于怀孕,术前和术后护理可能需要进行某些检查,而这些检查并非外科手术的标准检查,也可能被主治妇科医生忽视:一名妊娠 31 周的患者因急性阑尾炎急性发作来到产科门诊。在完成所有必要的检查和全面的多学科评估后,成功实施了腹腔镜阑尾切除术。随后的住院治疗因子宫收缩而变得复杂,为此,医生使用了催产素和皮质类固醇治疗,以促使胎儿肺部成熟:在本病例报告中,我们举例说明了适当的多学科方法,并分析了为使胎儿和母亲以及手术团队获得最大利益而应采取的具体步骤。在讨论中,我们概述了为患者利益和法医原因而应遵循的步骤。
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来源期刊
Visceral Medicine
Visceral Medicine Medicine-Surgery
CiteScore
4.50
自引率
0.00%
发文量
40
期刊介绍: This interdisciplinary journal is unique in its field as it covers the principles of both gastrointestinal medicine and surgery required for treating abdominal diseases. In each issue invited reviews provide a comprehensive overview of one selected topic. Thus, a sound background of the state of the art in clinical practice and research is provided. A panel of specialists in gastroenterology, surgery, radiology, and pathology discusses different approaches to diagnosis and treatment of the topic covered in the respective issue. Original articles, case reports, and commentaries make for further interesting reading.
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