Acute appendicitis during pregnancy: a literature review

Domantas Jakštas1, Antanas Dambrauskas1, Gabija Mockevičiūtė1 

1Lithuanian University of Health Sciences, Medical academy, Faculty of Medicine

Abstract

 

Background: Acute appendicitis is the most common non obstetric emergency in pregnant women. However, contrary to the general population, diagnosis of this disease is often difficult due to the various anatomical and physiological changes that occur during pregnancy. Due to the enlarged uterus that results in a dislocation of the appendix and changes in patients blood composition, such as physiological leucocytosis, manifesting symptoms of acute appendicitis might be misleading. Therefore, this condition is often associated with a late diagnosis and frequent complications such as perforation and fetal loss.

Aim: to evaluate effective diagnostic and treatment modalities for acute appendicitis during pregnancy.

Materials and methods: the review of literature was conducted using ”PubMed” database. We conducted a literature search using the predetermined keywords, and analysed an extensive amount of publications regarding the aspects of diagnosis and treatment of this disease.

Results: after conducting the review of literature we determined the best diagnostic approach for this condition – ultrasound and MRI. As for treatment, the most effective modality remains urgent surgery.

Discussion: The findings of clinical examination and laboratory tests may be misleading and can be a factor leading to a late diagnosis. Therefore, we have determined that the most accurate tests for this condition are radiological and the best treatment is surgical intervention.

Keywords: acute appendicitis, pregnancy, imaging, treatment